Mehmet AKIN, Cengiz YILMAZ, Bozkurt GÜLEK, Ömer KAYA, Okan DILEK, Gökhan SÖKER

Fokal karaciğer lezyonlarının saptanmasında single shot fast spin echo, Fiesta ve Propeller T2A MR sekanslarının etkinliklerinin karşılaştırılması

Amaç: Bu çalışmanın amacı, karaciğer lezyonlarının manyetik rezonans görüntüleme (MRG) T2-PROPELLER, T2-FIESTA ve T2-SSFSE sekanslarında sinyal özelliklerinin ve değerlendiriciler arasındaki farkın karşılaştırılmasıdır. Gereç ve Yöntem: Bu çalışma, Adana Numune Eğitim ve Araştırma Hastanesinde Ocak 2014-Temmuz 2016 tarihleri arasında çekimi yapılmış üst abdomen MR görüntüleriyle yapılmıştır. 5 mm ve daha büyük karaciğer lezyonları değerlendirilmiş, lezyon boyutunda üst sınır belirlenmemiştir. Birden fazla karaciğer lezyonu olan hastalarda en fazla 4 lezyon değerlendirmeye alınmıştır. Karaciğer fokal lezyonları sinyal özelliklerine göre 5 kategoride sınıflandırılmıştır. Değerlendiriciler, hastaların karaciğer lezyonu olup olmadığından habersiz olarak sekansları incelemiştir. Bulgular: Çalışmaya 301 lezyon dahil edildi. Hastaların 63’ü (%36) erkek, 110’u (%64) kadındı. Hastaların yaşları 19 ile 90 yıl arasında değişmekteydi. Lezyonların 40’ı (%13,3) malign ve 261’i (%86,7) benign lezyonlardı. 301 lezyondan 148’i (%49,2) hemanjiom, 90’ı (%29,9) kist ve 32’si (%10,6) metastaz olarak saptandı. Lezyonların sinyal özelliklerinin karşılaştırılmasında, tekrarlı ölçümler analizinde sınıf içi korelasyon katsayısı 0,962 olarak bulundu. Sonuç: Sekanslar arasında lezyonların sinyal özelliğini karakterize etmede anlamlı fark saptanmamıştır.

Anahtar Kelimeler:

Karaciğer lezyonları, MRG, T2A, PROPELLER, FIESTA, SSFSE

The comparison of the efficacy of the single shot spin echo, fiesta, and propeller T 2 - weighted MRI sequences in the detection of focal liver lesions

Purpose: The purpose of this study is to compare the signal characteristics of liver lesions and the difference between interpreters in magnetic resonance imaging (MRI) T2-PROPELLER, T2-FIESTA, and T2-SSFSE sequences. Materials and Methods: This study was performed with upper abdominal MR images examined between January 2014-July 2016 at Adana Numune Training and Research Hospital were included in the study. Liver lesions with a diameter of 5 mm or more were taken into consideration, there was no upper limit on lesion size. Up to 4 lesions were evaluated in patients with more than one liver lesion. Focal liver lesions were categorized into 5 groups according to signal properties. The interpreters blindly evaluated the sequences, without priorly knowing if the patients had liver lesions or not. Results: 301 lesions were included in the study. 63 (36%) of the patients were males, while 110 (64%) were females. The ages of the patients varied between 19 and 90 years. 40 (13.3%) of the lesions were malignant, while 261 (86.7%) were benign. Of the 301 lesions, 148 (49.2%) were hemangiomas, 90 (29.9%) were cysts, and 32 (10.6%) were metastases. In comparison of signal characteristics of lesions, the intraclass correlation coefficient of the repeated measurement analysis was found to be 0.962. Conclusion: There was no significant difference in characterizing the signal characteristic of the lesions between the sequences.

Keywords:

Liver lesions, MRI, T2W, PROPELLER, FIESTA, SSFSE,

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1. Karahan OI, Yıkılmaz A, Işın S. Karaciğer solid kitlelerinin renkli doppler ultrasonografi bulguları. İnönü Üniverstesi Tıp Fakültesi Dergisi. 2003;10:139- 42.
2. Galea N, Cantisani V, Taouli B. Liver lesion detection and characterization: role of diffusion-weighted imaging. J Magn Reson Imaging. 2013;37:1260-76.
3. Tello R, Fenlon HM, Gagliano T. Prediction rule for characterization of hepatic lesions revealed on MR imaging: estimation of malignancy. AJR Am J Roentgenol. 2001;176:879-84.
4. Bittner RC, Felix R. Magnetic resonance (MR) imaging of the chest: state-of-the-art. Eur Respir J. 1998;11:1392-404.
5. Müller NL. Computed tomography and magnetic resonance imaging: past, present and future. Eur Respir J. 2002;35:3-12.
6. Christoph U, Herborn FV, Lauenstein TC. MRI of the Liver: Can True FISP Replace HASTE?. J Magn Reson Imaging. 2003;17:190-6.
7. Tang Y, Yamashita Y, Namimoto T, Abe Y, Takahashi M. Liver T2-weighted MR imaging: comparison of fast and conventional half-Fourier single-shot turbo spin-echo, breath-hold turbo spinecho, and respiratory-triggered turbo spin-echo sequences. Radiology. 1997;203:766-72.
8. Foley WD, Kneeland JB, Cates JD. Contrast optimization for the detection of focal hepatic lesions by MR imaging at 1.5 T. AJR Am J Roentgenol. 1987;149:1155-60.
9. Agostini A, Kircher MF, Do RK, Borgheresi A, Monti S, Giovagnoni A, et al. Magnetic resonance imaging of the liver (including biliary contrast agents)—part 2: protocols for liver magnetic resonanance imaging and characterization of common focal liver lesions. Semin Roentgenol. 2016;51:317-33.
10. Pipe JG. Motion correction with PROPELLER MRI: application to head motion and free-breathing cardiac imaging. Magn Reson Med. 1999;42:963-9.
11. Yuusuke H, Hiroyoshi I, Yoji SM. mri artifact reduction and quality improvement in the upper abdomen with PROPELLER and Prospective Acquisition Correction (PACE) Technique. AJR. 2008;191:1154-8.
12. McFarland EG, Mayo-Smith WW, Saini S, Hahn PF, Goldberg MA, Lee MJ. Hepatic hemangiomas and malignant tumors: improved differentiation with heavily T2-weighted conventional spin-echo MR imaging. Radiology. 1994;193:43-7.
13. Van Hoe L, Bosmans H, Aerts P. Focal liver lesions: fast T2-weighted MR imaging with half-Fourier rapid acquisition with relaxation enhancement. Radiology. 1996;201:817-23.
14. Tang Y, Yamashita Y, Namimoto T, Takahashi M. Characterization of focal liver lesions with halfFourier acquisition single-shot turbo spin-echo (HASTE) and inversion recovery (IR)-HASTE sequences. J Magn Reson Imaging. 1998;8:438-45.
15. Yu JS, Kim KW, Kim YH, Jeong EK, Chien D. Comparison of multishot turbo spin echo and HASTE sequences for T2-weighted MRI of liver lesions. J Magn Reson Imaging. 1998;8:1079-84.
16. Lee MG, Jeong YK, Kim JC. Fast T2-weighted liver MR imaging: comparison among breath-hold turbospin-echo, HASTE, and inversion recovery (IR) HASTE sequences. Abdom Imaging. 2000;25:93-9.
17. Bhosale P, Ma J, Choi H. Utility of the FIESTA pulse sequence in body oncologic imaging. AJR. 2009;192:83-93.
18. Helmberger TK, Schroder J, Holzknecht N. T2- weighted breath hold imaging of the liver: a quantitative and qualitative comparison of fast spin echo and half Fourier single shot fast spin echo imaging. MAGMA. 1999;9:42-51.