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AIM: To evaluate the efficacy of ferucarbotran-enhanced MR imaging in the detection of focal hepatic lesions compared to plain and Gd-DTPA-enhanced MR imaging.METHODS: Fifty-nine patients with suspected focal hepatic lesions were admitted to the study. Plain MR imaging (FSE T2WI with fat suppression and GRE T1WI sequences) and Gd-DTPA dynamic enhanced MR of the liver were initially performed. followed by ferucarbotranenhanced MR imaging 48 h later (including GRE T1WI, FSE T2WI with fat suppression, and GRE T2*WI sequences). Images were reviewed independently by three observers. Results were correlated with surgery and pathologic examination or reference examination,and sensitivity was statistically calculated for the different MR imaging sequences.RESULTS: Among all confirmed lesions (n = 133),ferucarbotran-enhanced MR imaging revealed 130 lesions on FSE T2WI with fat suppression, 115 lesions on dynamic T1WI GRE, and 127 lesions on GRE T2*WI.Pre-contrast MR imaging revealed only 84 lesions on GRE T1WI and 106 lesions on FSE T2WI with fat suppression, while Gd-DTPA dynamic enhanced GRE T1WI revealed 123 lesions. For 44 micro-lesions (＜ 1.0cm) in all patients the detection rates were as follows:ferucarbotran-enhanced FSE T2WI with fat suppression,93.2% (41/44); ferucarbotran-enhanced GRE T2*WI,88.6% (39/44); Gd-DTPA dynamic-enhanced GRE T1WI, 79.5% (35/44); pre-contrast FSE T2WI with fat suppression, 54.5% (24/44); and pre-contrast GRE T1WI,34.1% (15/44). In detecting micro-lesions, statistically significant difference was found for Ferucarbotranenhanced FSE T2WI with fat suppression and GRE T2*WI sequences compared to the other sequences (P ＜ 0.05).CONCLUSION: Ferucarbotran-enhanced FSE T2WI with fat suppression and GRE T2*WI sequences are superior in detecting micro-lesions (＜ 1 cm) in comparison with plain and Gd-DTPA dynamic-enhanced MR imaging.