Basic MRI Protocol for Liver Masses
At the authors' institution, the following sequences are used as the standard techniques for MRI of the liver:
Coronal ultrafast spin-echo sequence (single breath-hold), which serves as a localizer and provides an overview of the anatomy. T2-weighted images help characterize lesions.
Axial fast spin-echo (T2-weighted) images through the liver. Fat-saturated (frequency selective) images increase the conspicuity of liver lesions.
Axial 2D dual spoiled gradient-recalled echo sequence (SPGR) (both out-of-phase and in-phase imaging during a single breath-hold). This provides T1 information and helps detect focal or diffuse fatty infiltration (loss of signal on out-of-phase sequence).
Diffusion-weighted sequences using b-values of 0,500 and 1000 with ADC maps.
THRIVE SPGR sequences with fat saturation without and with contrast. This sequence is valuable for the detection and characterization of lesions on the basis of their enhancement patterns. Additional delayed imaging is performed with Eovist (Gadotexetate disodium, Bayer HealthCare Pharmaceuticals Inc, Wayne, NJ-07470, Mfd. in Germany), if needed. The unenhanced images can be subtracted from those obtained after contrast administration to better assess enhancement characteristics.
Appl Radiol. 2014;43(12):20-28. © 2014 Anderson Publishing, Ltd.