You can set the NotifyFilter-property to LastAccess, and catch the Changed-event. Like this:
FileSystemWatcher lWatcher = new FileSystemWatcher(@"C:\Documents and Settings\User\Desktop", "myfile.txt");
lWatcher.NotifyFilter = NotifyFilters.LastAccess;
lWatcher.Changed += new FileSystemEventHandler(HandlerWatcherChanged);
void HandlerWatcherChanged(object sender, FileSystemEventArgs e)
{
// file has been accessed
}