RESUMEN
To determine the accuracy of magnetic resonance (MR) imaging relative to computed tomography (CT) in the diagnosis of liver metastases, a randomized, controlled study was conducted of 135 subjects, including 57 with cancer metastatic to the liver, 27 with benign cysts or hemangiomas, and 51 without focal liver disease. The sensitivity of MR imaging for detecting individual metastatic deposits was 64%, significantly greater than 51% for CT (P less than .001); the difference in sensitivity for identifying patients with one or more hepatic metastases was less (82% for MR imaging vs. 80% for CT). In patients without hepatic metastases, the specificity of MR imaging was 99% versus 94% for CT. Significant differences were found between individual MR pulse sequences in detection of individual lesions. The sensitivity of both T1-weighted spin-echo (SE) (64%) and inversion-recovery (IR) (65%) pulse sequences was significantly (P less than .001) greater than either the TE (echo time) 60 msec (43%) or TE 120 msec (43%) T2-weighted pulse sequences. Overall, the accuracy of a single T1-weighted (10-minute) pulse sequence was superior to that of contrast-enhanced CT.
Asunto(s)
Neoplasias Hepáticas/secundario , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Adulto , Anciano , Ensayos Clínicos como Asunto , Neoplasias del Colon/diagnóstico , Neoplasias del Colon/diagnóstico por imagen , Quistes/diagnóstico , Quistes/diagnóstico por imagen , Diagnóstico Diferencial , Reacciones Falso Negativas , Reacciones Falso Positivas , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/diagnóstico por imagen , Humanos , Neoplasias Renales/diagnóstico , Neoplasias Renales/diagnóstico por imagen , Hepatopatías/diagnóstico , Hepatopatías/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/diagnóstico por imagen , Persona de Mediana Edad , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/diagnóstico por imagen , Distribución Aleatoria , Neoplasias del Bazo/diagnóstico , Neoplasias del Bazo/diagnóstico por imagenRESUMEN
Twenty-four patients with acute sigmoid diverticulitis and associated pelvic fluid collections seen on computed tomographic scans underwent percutaneous catheter drainage as an adjunct to surgical therapy. Fourteen of the 24 underwent a single-stage surgical procedure within 10 days of drainage. Five patients required two-stage surgical procedures because localized inflammatory changes precluded a primary resection despite the absence of a residual abscess at surgery. Two of the three remaining patients initially had no surgery, but they had recrudescences of their symptoms that required surgical drainage within 8 months. One patient in whom surgical resection was deferred remained asymptomatic 10 months after percutaneous drainage. A retrospective review of 87 patients undergoing surgery for diverticulitis suggested that the percentage of two-stage surgical procedures has decreased in the last 5-10 years, but there remains a substantial number of patients who might benefit from percutaneous catheter drainage of diverticular abscess of the sigmoid colon.
Asunto(s)
Absceso/cirugía , Diverticulitis del Colon/cirugía , Drenaje/métodos , Enfermedades del Sigmoide/cirugía , Enfermedad Aguda , Diverticulitis del Colon/diagnóstico por imagen , Humanos , Estudios Retrospectivos , Enfermedades del Sigmoide/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
One hundred eighty-seven diagnostic and therapeutic interventional procedures in the pleural space were performed by using sonographic guidance. These consisted of diagnostic aspiration (118), drainage of malignant and nonmalignant effusions (41), empyema drainage (17), pleural sclerotherapy with tetracycline or bleomycin (7), and pleural biopsy (4). Diagnostic aspiration was performed with 20-gauge needles, and therapeutic and empyema drainages were performed by trocar technique with either a 7-French Sacks catheter or a specially designed empyema drainage catheter. Pneumothoraces were seen in 3% of the patients, and most of these were treated by the radiologist with placement of a Heimlich valve. We conclude that the use of sonography allows rapid localization of pleural fluid collections and instant monitoring of drainage of noninfected fluid collections and empyemas.
Asunto(s)
Empiema/patología , Derrame Pleural/patología , Ultrasonografía , Biopsia , Biopsia con Aguja , Drenaje , Empiema/terapia , Humanos , Pleura/patología , Derrame Pleural/terapia , Soluciones Esclerosantes/administración & dosificaciónRESUMEN
High-frequency, high-resolution sonography was used to detect recurrent thyroid carcinoma in 73 patients with papillary carcinoma, 16 with medullary carcinoma, 10 with follicular carcinoma, and one with small-cell carcinoma. Of the 36 patients with negative sonograms, 35 had no other evidence of recurrence, while one had surgical proof of recurrence. Of 25 patients with positive sonograms, confirmed with surgery or radioactive iodine (I131) scanning (sonographic sensitivity 96%, specificity 83%), palpation was negative in 17 (palpation sensitivity 32%, specificity 100%). Thirty-two patient with positive sonographic findings had no objective clinical proof of recurrence. There were seven false-positive studies. This study suggests that sonography may be the method of choice for earliest detection and localization of recurrent carcinoma of the thyroid.
Asunto(s)
Adenocarcinoma/diagnóstico , Carcinoma Papilar/diagnóstico , Carcinoma/diagnóstico , Recurrencia Local de Neoplasia/diagnóstico , Neoplasias de la Tiroides/diagnóstico , Ultrasonografía , Reacciones Falso Positivas , Estudios de Seguimiento , HumanosRESUMEN
Nonferrous needles of pure brass, titanium, or copper, and ferrous needles of different alloys of stainless steel were analyzed for the size, area, and distribution of the image artifact created when the needles were placed in a 0.6-T magnet. Results demonstrated that a stainless steel prototype needle (type 316) would be visible on magnetic resonance images and would provide an artifact similar to that seen in computed tomographic-guided biopsies. Further testing of this prototype included assessment of the effect on the artifact when changes were made in annealing properties, gauge, length, needle-tip geometry, pulse sequence, and orientation relative to the magnetic field. To date, three human liver biopsies have been successfully and safely performed using a stainless steel type 316 needle.
Asunto(s)
Biopsia con Aguja/instrumentación , Espectroscopía de Resonancia Magnética , Agujas , Anciano , Cobre , Diseño de Equipo , Femenino , Humanos , Acero Inoxidable , Titanio , ZincRESUMEN
Sixty-two patients who presented with subphrenic abscesses had the abscesses drained percutaneously. Diagnosis of a subphrenic collection was usually made with sonography. Initial percutaneous drainage was accomplished with a combination of sonography and fluoroscopic guidance. More recently (in the last 31 cases) most drainages were done with sonographic guidance alone. Successful catheter drainage was achieved in 85% with a complication rate of 4.8%. Failure of catheter drainage (defined as any patient who was not cured by percutaneous drainage alone) occurred in patients with multiple collections or in whom the primary cause of the abscess necessitated surgery, for example, perforated ulcer, acute cholecystitis. Considerations for successful drainage include understanding the anatomy of the subphrenic space, recognizing the importance of a correct access route (avoidance of the pleura and lung), and the long time necessary for adequate drainage (longer than 10 days in 60%). An angled subcostal approach to the subphrenic space was used in 56 (90%) of 62 cases. No complications occurred in this group. The one pneumothorax that occurred in the remaining six cases was a direct result of using an intercostal approach through the parietal pleura into a subphrenic collection. We conclude that percutaneous drainage is a safe and effective method of treatment of subphrenic abscesses.
Asunto(s)
Drenaje/métodos , Absceso Subfrénico/cirugía , Cateterismo/métodos , Drenaje/efectos adversos , Fluoroscopía , Humanos , Masculino , Persona de Mediana Edad , Absceso Subfrénico/diagnóstico , Factores de Tiempo , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
The magnetic resonance features of a case of focal nodular hyperplasia are described. They include mass effect with tumor nearly isointense with adjacent liver and a central stellate region corresponding pathologically to the collagenous scar.
Asunto(s)
Hígado/patología , Espectroscopía de Resonancia Magnética , Adenoma/diagnóstico , Adulto , Angiografía , Diagnóstico Diferencial , Femenino , Hemangioma/patología , Humanos , Hiperplasia , Hígado/irrigación sanguínea , Hígado/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico , CintigrafíaRESUMEN
Eighty-nine biliary strictures in 73 patients who had undergone percutaneous balloon dilatation were reviewed to determine long-term patency rates and clinical management problems. The majority of dilatations were performed in patients with anastomotic strictures (n = 44), iatrogenic strictures (n = 28), and strictures associated with sclerosing cholangitis (n = 17). Patency rates after 36 months or more were 67%, 76%, and 42%, respectively. Complications, mostly minor, occurred in less than 7% of patients. Of patients with significant biliary obstruction, 15% had little or no intrahepatic biliary duct dilatation demonstrated by cross-sectional imaging and/or direct cholangiography. No definite conclusions could be drawn about the utility of long-term internal/external stenting.
Asunto(s)
Enfermedades de los Conductos Biliares/terapia , Enfermedades de los Conductos Biliares/diagnóstico por imagen , Enfermedades de los Conductos Biliares/etiología , Cateterismo/métodos , Colangitis/complicaciones , Constricción Patológica/diagnóstico por imagen , Constricción Patológica/etiología , Constricción Patológica/terapia , Dilatación/métodos , Femenino , Humanos , Persona de Mediana Edad , Complicaciones Posoperatorias/terapia , Radiografía , Estudios RetrospectivosRESUMEN
Sixteen patients with known rectal cancer were evaluated and staged with CT and MR, and at surgery. Detailed evaluation of the pathologic specimens was performed and correlated with CT and MR to determine the accuracy of staging. Most of the cases were advanced stages, and both CT and MR were equally effective in staging. Prone positioning using an air-distension technique was equally important for CT and MR examinations. Because of a positive contrast material (iodine), adequate CT examinations could be performed without prior bowel preparation; however, bowel cleansing was necessary for MR examinations. Both techniques could identify the primary tumor and invasion into perirectal fat and local organs. Neither CT nor MR were able to assess the extent of bowel-wall infiltration or tumor spread to normal size perirectal lymph nodes.
Asunto(s)
Espectroscopía de Resonancia Magnética , Neoplasias del Recto/diagnóstico , Tomografía Computarizada por Rayos X , Aire , Medios de Contraste , Femenino , Humanos , Metástasis Linfática , Masculino , Invasividad Neoplásica , Estadificación de Neoplasias , Postura , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Recto/patologíaRESUMEN
Forty-three patients with liver metastases were imaged using 14 different pulse sequences (average, 7.5 sequences per patient) to allow direct comparison of their performance. "T2-weighted" spin-echo (SE) images, "T1-weighted" inversion recovery (IR) images, and "T1-weighted" SE images were obtained using a wide range of timing parameters. Pulse sequence performance was quantitated by measuring liver signal-to-noise (S/N) ratios and cancer-liver signal difference-to-noise (SD/N) ratios. Data were standardized to reflect a constant imaging time of 9 minutes for all pulse sequences. The SE 2,000/120 (TR [repetition time]/TE [echo time]) sequence resulted in the greatest SD/N ratio of the T2-weighted SE sequences but also yielded the low S/N ratios, poor anatomic resolution, and motion artifacts common to all T2-weighted SE images. IR sequence images were also sensitive to motion artifacts because of the use of a long TR (1,500 msec). Short TR/TE T1-weighted SE sequences (SE 260/18) had the greatest SD/N ratio (P less than .05), S/N ratio, and anatomic resolution. Furthermore, extensive signal averaging appears to be a powerful solution to all types of motion artifacts in the abdomen.
Asunto(s)
Neoplasias Hepáticas/secundario , Espectroscopía de Resonancia Magnética , Adenocarcinoma/diagnóstico , Adenocarcinoma/metabolismo , Adenoma de Células de los Islotes Pancreáticos/diagnóstico , Adenoma de Células de los Islotes Pancreáticos/metabolismo , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/metabolismo , Humanos , Neoplasias Hepáticas/diagnósticoRESUMEN
We undertook this study to determine whether a computed tomography-guided, percutaneous preoperative drainage of a peridiverticular abscess can safely allow a one-stage procedure in patients requiring surgery for acute diverticulitis. In 17 patients evaluated prospectively by computed tomography, thin-needle aspiration demonstrated purulent fluid collection in 11 patients. Percutaneous catheter drainage was undertaken in eight patients. In the three remaining patients, the abscess was either too small to warrant drainage or no safe access route was present. Seven of eight patients had a single-stage resection within one to three weeks of percutaneous catheter drainage. There were no complications. Our studies suggest that a combined radiological-surgical approach has the potential to reduce morbidity and hospital costs without increasing mortality in the management of perforated colon diverticulitis with associated abscess formation.
Asunto(s)
Absceso/cirugía , Diverticulitis del Colon/cirugía , Drenaje/métodos , Tomografía Computarizada por Rayos X , Absceso/diagnóstico por imagen , Absceso/etiología , Anciano , Diverticulitis del Colon/complicaciones , Diverticulitis del Colon/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A computed tomographic (CT) guided transgluteal approach through the greater sciatic foramen was used to drain pelvic abscesses and fluid collections in 21 patients. Ideal catheter placement should traverse the lower portion of the greater sciatic foramen at the level of the sacrospinous ligament. This avoids the vascular and neural elements that are located slightly cephalad at the level of the piriformis muscle. Percutaneous drainage through this approach was successful in avoiding surgery in 17 patients (81%). Pain was the most common complication and was generally associated with a more cephalad approach, transgressing the piriformis and the sacral plexus. CT-guided percutaneous drainage of pelvic abscesses through the greater sciatic foramen should be used when the more standard transperitoneal approach is not possible.
Asunto(s)
Absceso/cirugía , Nalgas/diagnóstico por imagen , Drenaje , Enfermedad Inflamatoria Pélvica/cirugía , Pelvis/diagnóstico por imagen , Absceso/diagnóstico por imagen , Cateterismo/efectos adversos , Drenaje/métodos , Femenino , Estudios de Seguimiento , Plexo Lumbosacro/diagnóstico por imagen , Masculino , Dolor/etiología , Enfermedad Inflamatoria Pélvica/diagnóstico por imagen , Punciones , Sacro/diagnóstico por imagen , Nervio Ciático/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Pancreatic necrosis is a potential sequela of acute pancreatitis, which pathologically represents a collection of devitalized tissue. Appropriate therapeutic planning requires definition of this irreversibly damaged gland, the presence of which is not consistently diagnosed on the basis of clinical and laboratory data. Over an 18-month period, 22 patients with pancreatic necrosis were studied by one or more computed tomographic (CT) examinations. Retrospective analysis showed the findings to vary with the developmental stage of the necrotizing process. During the acute phase, there was considerable morphologic overlap of necrosis and pancreatic phlegmon. Typical findings were seen in the subacute and chronic stages and included diffuse enlargement of the gland with largely decreased central density. A thick, smooth surrounding rim produced a characteristic saclike configuration. CT-guided aspiration for culture material was performed in four patients with suspected superinfection. Negative gram stain and culture results in two patients allowed surgery to be performed on a more elective basis.
Asunto(s)
Páncreas/diagnóstico por imagen , Pancreatitis/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Enfermedad Aguda , Adulto , Anciano , Drenaje , Femenino , Humanos , Masculino , Persona de Mediana Edad , Necrosis , Páncreas/patología , Pancreatitis/microbiología , Pancreatitis/patología , Estudios Retrospectivos , UltrasonografíaRESUMEN
Eleven patients with postoperative abdominal and pelvic lymphoceles underwent percutaneous diagnostic and therapeutic intervention with either needle aspiration or catheter drainage. Although initial sonographic or CT examinations accurately identified these collections, definitive diagnosis required fluid sampling and laboratory analysis for confirmation. Seven pelvic and two retroperitoneal lymphoceles demonstrated a gross appearance and composition different from two lymphatic collections in the upper peritoneum. Nine patients underwent catheter drainage; two were managed by needle aspiration alone. Duration of catheter drainage was 4-120 days, substantially longer than is customary for standard fluid collections. Nine of 11 patients were cured by percutaneous aspiration or drainage alone. Bacterial colonization developed in three persistently draining lymphoceles. However, no clinical sepsis or bacteremia occurred. In another patient with persistent high-volume lymphatic output, sclerotherapy with tetracycline instillation was successful in rapidly closing the lymphatic fistula. Percutaneous drainage is a safe, effective procedure for drainage of postoperative lymphoceles.
Asunto(s)
Quistes/cirugía , Drenaje/métodos , Enfermedades Linfáticas/cirugía , Adulto , Anciano , Quistes/diagnóstico por imagen , Quistes/etiología , Femenino , Humanos , Enfermedades Linfáticas/diagnóstico por imagen , Enfermedades Linfáticas/etiología , Masculino , Persona de Mediana Edad , Pelvis , Complicaciones Posoperatorias , Espacio Retroperitoneal , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Magnetic resonance (MR) imaging of the adrenal glands with a prototype surface coil was compared with conventional body coil images in five healthy volunteers and 15 patients with adrenal disease. The spectrum of abnormalities included five nonfunctioning cortical adenomas, of which two were in hyperplastic glands, four adrenal metastases, three pheochromocytomas, a functioning adenoma, a myelolipoma, and a partially calcified, cystic adrenal mass. In both body and surface coil images, anatomic detail was superior on T1-weighted images compared with T2-weighted images obtained with identical imaging time because of decreased motion artifact and superior contrast. In the T1-weighted studies, high-resolution surface coil images showed a threefold improvement in signal-to-noise ratio (SNR) over body coil images, which was manifest by better intrinsic resolution of small adrenal lesions and clearer definition of the extrinsic relationships of large masses to nearby organs. In addition, inferior vena caval invasion by two right adrenal metastases was better demonstrated using the surface coil than body coil MR or computed tomography (CT). Limitations of surface coil imaging include restriction in the field of view to a single gland and additional time required for patient positioning. Since the sensitivity of surface coils diminishes with depth, gains in SNR were limited in large patients with deeper adrenal glands. Despite these limitations, dramatic improvements in SNR and anatomic resolution indicate that surface coil MR imaging will be competitive with CT for examining the adrenal glands.
Asunto(s)
Enfermedades de las Glándulas Suprarrenales/diagnóstico , Glándulas Suprarrenales/patología , Espectroscopía de Resonancia Magnética/métodos , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Adulto , Anciano , Humanos , Espectroscopía de Resonancia Magnética/instrumentación , Persona de Mediana EdadRESUMEN
Eight healthy volunteers and 11 patients with pancreatic abnormalities were studied using a conventional body coil and a prototype magnetic resonance (MR) surface coil. Final pathologic diagnoses included carcinoma of the head (six), body (one), and tail of the pancreas (two) and chronic pancreatitis (two). In surface coil images of the volunteers, the body and tail of the pancreas was visualized in all cases but one, and the pancreatic duct was seen in five of eight cases. In-plane spatial resolution of 0.9 X 0.9 mm and 5-mm section thickness was obtained. At the same time, pancreatic surface coil images had a twofold improvement in the signal-to-noise ratio (SNR) compared with body coil images. T1-weighted spin-echo images gave greater SNR, reduced motion artifacts, provided superior anatomic detail, and offered more diagnostic information than comparable T2-weighted images. Significant abnormalities detected only by surface coil imaging included a small tumor surrounded by reactive edema and periglandular tumor invasion. This study demonstrates that surface coil imaging of the pancreas not only is feasible but provides an improved method for examining the pancreas by MR.
Asunto(s)
Espectroscopía de Resonancia Magnética/métodos , Páncreas/patología , Enfermedades Pancreáticas/diagnóstico , Adulto , Anciano , Humanos , Espectroscopía de Resonancia Magnética/instrumentación , Persona de Mediana Edad , Neoplasias Pancreáticas/diagnósticoRESUMEN
Fifty-three samples of gallbladder bile were obtained at the time of cholecystectomy from patients with the clinical diagnosis of acute or chronic cholecystitis. Five bile samples from patients with clinically normal gallbladders also were obtained. Proton magnetic resonance (MR) relaxation times, protein content, and water content were determined for the bile samples, and the data were grouped according to pathologic diagnosis, which disclosed 11 cases of acute cholecystitis, 41 cases of chronic cholecystitis, and six normal gallbladders. There was no significant difference in the mean T1 and T2 values between the groups with acute and chronic cholecystitis. Patients with chronic cholecystitis were found to have more concentrated bile than those with acute cholecystitis. Protein content varied widely within both groups of patients. We conclude that T1 and T2 relaxation times do not reliably differentiate acute from chronic cholecystitis.
Asunto(s)
Bilis , Colecistitis/diagnóstico , Espectroscopía de Resonancia Magnética , Bilis/análisis , Colecistitis/metabolismo , HumanosRESUMEN
The portability of modern real-time ultrasound units has led to a marked increase in the demand for examinations in medical, surgical, and pediatric intensive care units, the pediatric nursery, and the operating room. The results of all portable ultrasound examinations in the medical and surgical intensive care units at the Massachusetts General Hospital over a four-month period were analyzed to determine the efficacy of such studies. Of 48 examinations, portable sonograms were useful in 90 per cent, found new, clinically important information in 17 per cent, and led to misleading information in 4 per cent. Portable ultrasound examinations are valuable clinically and are probably cost effective.
Asunto(s)
Equipos y Suministros de Hospitales/provisión & distribución , Administración Hospitalaria , Sistemas de Distribución en Hospital , Unidades de Cuidados Intensivos , Ultrasonografía/instrumentación , Boston , Estudios de Evaluación como Asunto , Hospitales con más de 500 Camas , HumanosRESUMEN
Stent endoprosthesis has been advocated as an alternative to internal-external catheter drainage for decompression of biliary obstruction, but drawbacks have never been specifically analyzed, to our knowledge. A retrospective review of 118 biliary stent endoprostheses placed in 113 patients assessed the frequency, nature, and treatability of significant complications. Complications were categorized as early (morbidity or mortality within the first 30 days) or late (after 30 days). The early complication rate was 17% (19/113); the late complication rate, 31% (32/102). Early complications were most often due to unstable stent positioning in technically difficult procedures involving periportal obstruction (4/8), while the most common late problems were lumen occlusion (23/102 [23%]), migrations (6/102 [6%]), and tumor overgrowth of the stent (3/102 [3%]). Neither the histologic features nor the location of the primary tumor correlated with the potential for long-term stent dysfunction. Specific treatment of complications was carried out in 17 of 102 patients (17%) and almost invariably required readmission and remanipulation or de novo biliary drainage.
Asunto(s)
Prótesis e Implantes/efectos adversos , Enfermedades de los Conductos Biliares/etiología , Enfermedades de los Conductos Biliares/terapia , Colestasis/cirugía , Conducto Colédoco/cirugía , Dilatación/instrumentación , Conducto Hepático Común/cirugía , HumanosRESUMEN
Twenty-one patients with hepatic hemangioma, five with hepatic cysts, and 25 with primary or metastatic cancer involving the liver were studied by magnetic resonance imaging (MRI). Benign lesions (hemangiomas, cysts) were diagnosed noninvasively by CT, radionuclide studies, and/or sonography and confirmed by follow-up examinations more than 1 year later. Malignant lesions were confirmed by liver biopsy in every case. Identical multisection/multiecho techniques were used in all patients to obtain T1-and T2-weighted spin-echo (SE) and inversion-recovery (IR) images. MRI detected more hemangiomas than any other imaging technique. Of 30 hemangiomas, 25 were spherical or ovoid with a homogeneous appearance and smooth, well defined margins. Cancer tended to have a heterogeneous appearance and poorly defined margins. On T2-weighted SE images obtained with 2000 msec TR and 60, 120, or 180 msec TE, hemangiomas had significantly greater contrast-to-noise ratios (C/N) than liver cancer (p less than 0.001). The SE 2000/120 sequence provided the single most useful image for distinguishing hemangiomas from cancers. When morphologic criteria are used in conjunction with measured C/N, MRI correctly distinguished cavernous hemangiomas from liver cancer with 90% sensitivity, 92% specificity, and an overall accuracy of 90%. Cysts had a low signal intensity on SE 500/30 images and could often be distinguished from hemangiomas and cancers that were nearly isointense relative to liver. IR images were sensitive for lesion detection but provided no tissue-specific information. The data indicate that T2-weighted SE imaging may become the procedure of choice for distinguishing cavernous hemangioma from liver cancer.