gadoxetic-acid-disodium and Hemangiosarcoma

To describe imaging characteristics of primary hepatic angiosarcoma on gadoxetate disodium-enhanced dynamic magnetic resonance imaging (MRI) and to determine features that differentiate angiosarcomas from similar-sized haemangiomas.. The study included 15 patients with hepatic angiosarcomas and 35 patients with size-matched hepatic haemangiomas who underwent gadoxetate disodium-enhanced liver MRI. The number, size, growth pattern, signal intensity (SI) characteristics, and SI changes on dynamic scans were evaluated and compared between the two entities.. Overall, hepatic angiosarcomas significantly more often showed lesion multiplicity (86.7%), capsular retraction (40%), prominent intratumoural vessels (66.7%), vascular invasion (20%), heterogeneous SI on T2-weighted (100%) and hepatobiliary phase images (80%), and intralesional haemorrhage (60%, all p<0.05). On dynamic scans, angiosarcomas demonstrated enhancing foci of irregular or rim-like nodular/linear or bizarre (86.7%) shapes, with centrifugal or bizarre patterns of progressive enhancement (53.3%). Enhancement of angiosarcomas was less than that of the blood pool on visual grading, but the enhancement curves followed that of the aorta. Regardless of size, angiosarcomas showed heterogeneous T2 SI, intratumoural haemorrhage, and heterogeneity during the hepatobiliary phase, whereas these findings were more common in haemangiomas >6 cm in diameter.. Gadoxetate disodium-enhanced dynamic liver MRI is capable of depicting vascular hallmarks of hepatic angiosarcomas. Heterogeneous SI on T2-weighted and hepatobiliary phase images, multiplicity, and an enhancement curve following that of the aorta are also distinctive features that differentiate angiosarcomas from haemangiomas.

Topics: Aged; Contrast Media; Diagnosis, Differential; Female; Gadolinium DTPA; Hemangioma; Hemangiosarcoma; Humans; Image Enhancement; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Sensitivity and Specificity

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