gadoxetic-acid-disodium and Hemangioendothelioma--Epithelioid

Topics: Contrast Media; Gadolinium DTPA; Hemangioendothelioma, Epithelioid; Humans; Liver; Liver Neoplasms; Magnetic Resonance Imaging

To examine the characteristic features of hepatic epithelioid hemangioendothelioma (HEH) on magnetic resonance imaging (MRI) using Gd-EOB-DTPA.. Twelve patients (mean age, 50 years; male:female = 6:6) who were pathologically confirmed to have HEH in two tertiary institutions were retrospectively investigated. For qualitative analysis, the MRI features of HEH including core pattern were characterized, and lesions were divided into core and non-core groups. For quantitative analysis, standardized mean signal intensities (SI. Forty-seven nodules in 12 patients were analyzed. The mean size of the lesions was 2.9 ± 1.0 cm. In the per-lesion analysis, ring-like arterial enhancement (74%) on arterial phase was the most frequent feature, followed by core pattern (51%), and hyperintense rim on T1-weighted imaging (43%). In the per-patient analysis, capsular retraction (75%) was the most common sign. The percentage of patients with core pattern was 58%. In the core group, the SI. Core pattern can be considered a new diagnostic sign of HEH.

Topics: Contrast Media; Female; Gadolinium DTPA; Hemangioendothelioma, Epithelioid; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Retrospective Studies

To assess the value of gadoxetic acid-enhanced and diffusion-weighted (DW) magnetic resonance (MR) imaging for differentiating primary hepatic angiosarcomas from hemangiomatosis and epithelioid hemangioendotheliomas (EHEs).. We reviewed MR images of seven patients with pathologically determined hepatic angiosarcomas, 11 patients with hemangiomatosis, and five patients with EHEs. Two radiologists assessed morphologic features, signal intensity (SI), enhancement patterns, and the presence of diffusion restriction by consensus and compared between angiosarcoma vs hemangiomatosis and angiosarcoma vs EHEs.. Angiosarcomas more frequently showed mixed well- and ill-defined margins (6, 85.7%), mixed strong and intermediate-high SI (5, 71.4%) on T2-weighted images, mixed peripheral and/or central nodular and rim and/or target enhancement (5, 71.4%), and mixed presence and absence of diffusion restriction (7, 100%) compared with hemangiomatosis and EHEs (P < 0.05). The overall survival rate in patients with angiosarcomas was 42.9% at 3 months and 14.3% at 14 months, whereas all patients with EHEs were alive during the follow-up period from 4 to 43 months (P = 0.002).. Gadoxetic acid-enhanced and DW MR imaging may help differentiate primary hepatic angiosarcomas with hemangioma-like appearance, EHE-like appearance, or both; and poor prognosis from hemangiomatosis and EHEs.

Topics: Adult; Aged; Contrast Media; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Female; Gadolinium DTPA; Hemangioendothelioma, Epithelioid; Hemangioma; Hemangiosarcoma; Humans; Image Enhancement; Liver; Liver Neoplasms; Male; Middle Aged; Reproducibility of Results; Retrospective Studies

To investigate magnetic resonance imaging (MRI) characteristics of hepatic epithelioid hemangionendothelioma (HEH).. The study was exempted from formal Ethics Committee approval due to its retrospective and noninvasive nature. Eleven patients with histology-proven HEH were collected from six different institutions in a 5-year time period. In all patients a contrast-enhanced MR study was available. Two experienced reviewers in consensus retrospectively noted potential MR findings of HEH. Reviewers separately analyzed morphological findings, tumor signal intensity, HEH contrast enhancement pattern, and tumor appearance on hepatobiliary phase and diffusion-weighted imaging (DWI). The frequency of various findings was calculated.. The most frequent presentation was a peripheral distribution of the lesions (72.7%), target appearance on T2-weighted images (63.6%), low signal intensity on T1-weighted images (63.6%), ring or target-like enhancement at dynamic study (63.6%), and coalescence of nodules and capsular retraction (45.4%). Lack of hepatobiliary enhancement (5/8 patients) or "entrapment" hepatobiliary enhancement (3/8 patients) as well as target appearance at DWI (5/6 patients) was also observed in our series.. Although quite variable imaging appearances were seen, a target appearance on the T2-weighted image, ring or target enhancement at dynamic study, lack of enhancement or "entrapment" at hepatobiliary phase, and target appearance on DWI are frequent findings of HEH.

Topics: Adult; Contrast Media; Diffusion Magnetic Resonance Imaging; Female; Gadolinium DTPA; Hemangioendothelioma, Epithelioid; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Male; Meglumine; Middle Aged; Organometallic Compounds; Retrospective Studies