Comparison between turbo spin-echo and echo planar diffusion-weighted imaging of the female pelvis with 3T MRI

Background Echo-planar imaging (EPI)-diffusion-weighted imaging (DWI) may take unclear image affected by susceptibility, geometric distortions and chemical shift artifacts. Purpose To compare the image quality and usefulness of EPI-DWI and turbo spin echo (TSE)-DWI in female patients who required imaging of the pelvis. Material and Methods All 57 patients were examined with a 3.0-T MR scanner. Both TSE- and EPI-DWI were performed with b values of 0 and 1000 s/mm2. We compared geometric distortion, the contrast ratio (CR) of the myometrium to the muscle and the apparent diffusion coefficient (ADC) values for the myometrium and lesion. Two radiologists scored the TSE- and EPI-DWI of each patient for qualitative evaluation. Results The mean percent distortion was significantly smaller with TSE- than EPI-DWI (p = 0.00). The CR was significantly higher with TSE- than EPI-DWI (p = 0.003). There was a significant difference in the ADC value for the uterus and lesions between the EPI- and TSE-DWI (p < 0.05). Finally, the ADC values of cancer were significantly different from those for the uterus and benign with both the two sequences (p < 0.05). The scores for ghosting artifacts were higher with TSE- than EPI-DWI (p = 0.019). But there were no significant differences between TSE- and EPI-DWI with regard to image contrast and overall image quality. Conclusion TSE-DWI on the female pelvis by 3T MRI produces less distortion and higher CR than EPI-DWI, but there is no difference in contrast and image quality.