Atypical radiographic findings in hepatic cavernous hemangioma: correlation with histologic features

Takayasu, K; Moriyama, Noriyuki; Shima, Yasuo; Muramatsu, Yukio; Yamada, Takaharu; Makuuchi, Masatoshi; Yamasaki, Shin‐ichi; Hirohashi, Shinji

doi:10.2214/ajr.146.6.1149

Cited by 47 publications

(37 citation statements)

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“…Two small hemangiomas about 2 cm in diameter with rapid enhancement on the arterial domi nant phase showed relatively wide vascular space with thin intervening septa. In another small hemangioma, a delayed or minimal con trast enhancement area contained smaller vas cular channels intermingled with abundant fibrotic interstitium, as in the cases of Takayasu et al [12]. Another pathologic specimen with wide vascular channels was hypoechoic on sonography.…”

Section: Asonogram Shows 3-cmhomogeneously Hypoechoic Tumor (Arrows)mentioning

confidence: 84%

“…If these lesions are found in patients who do not belong to a risk group for malignant lesions such as hepatocellularcarcinomaor meta static tumors and the sonographic appearance is typically small and stronglyhyperechoic, then the patient is presumed to have a heman gioma and is advised to have regular follow ups without additional tests [3,11]. Many studies, however, suggest that atypical sono graphic appearance can be found even in small hemangiomas and that malignant tu mors can presentsonographicfindings similar to those of hemangioma [1,4,12]. Although radiolabeled RBC scintigraphy is a reliable test for the diagnosis of hepatic cavernous he mangioma, it does not readily localize small lesions and has a significant false-positive rate [2,4].…”

Section: Discussionmentioning

confidence: 99%

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Hepatic cavernous hemangioma: sonographic patterns and speed of contrast enhancement on multiphase dynamic MR imaging.

Yu¹,

Kim²,

Kim³

et al. 1998

American Journal of Roentgenology

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KiWhangKim1Jae-ChunChang3 Byung-JuneJo1 Tae-HoonKim1 JongTaeLee2 HyungSikYoo2 OBJECTIVE. Our purposewas to investigatea correlationbetweenthe speedof contrast enhancement in patientswith hepaticcavernoushemangiomarevealedby dynamicMR imag ing and the internal echo pattern revealed by sonography.MATERIALS AND METHODS. Forty-five patients underwent multiphase IV con trast-enhanced dynamic MR imaging that revealed7 1 hepaticcavernoushemangiomasless than 4 cm in diameter; the MR findingswere comparedwith the sonographicfindings in these patients.On MR imaging, the hemangiomaswere classifiedas rapid-, intermediate-, and slow-enhancing. We classified sonographic features as hypoechoic, iso-or mixed echoic, and hyperechoic according to the relative echogenicity seen between lesions and the surrounding hepatic parenchyma. Sonographic patterns and MR imaging findings of in dividual lesions were then compared.RESULTS. Rapid-enhancinghemangiomasrevealedon dynamic MR imaging tendedto be hypoechoic on sonography (18/24, 75%; p = .0143), and lesions that were slow-enhancing on MR imaging tended to be hyperechoic (26/29, 90%; p < .0001). Hypoechoic lesions on sonography tended to be rapid-enhancing on dynamic MR imaging (18/18, 100%). Likewise, hyperechoic lesions on sonography tended to be slow-enhancing on MR imaging (26/33, 79%; p = .0009). CONCLUSION.In mostpatientswith hepaticcavernoushemangiomas, we found that the speedof contrast enhancementon multiphase dynamic MR imaging enabled us to predict the echo pattern in sonography and vice versa.

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Section: Asonogram Shows 3-cmhomogeneously Hypoechoic Tumor (Arrows)mentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Hepatic cavernous hemangioma: sonographic patterns and speed of contrast enhancement on multiphase dynamic MR imaging.

Yu¹,

Kim²,

Kim³

et al. 1998

American Journal of Roentgenology

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“…This result differed from that on enhanced CT. 27,30 It is well known that hemangiomas show various types of enhancement in contrast-enhanced CT and MR imaging, and the possible correlation of the dynamic enhancement pattern of hepatic hemangiomas with the collective size of its constituent vascular spaces has been reported. [31][32][33] The vascular spaces of hemangiomas with diffuse enhancement are relatively small compared to those without diffuse enhancement. 33 Hanafusa's group 4 reported the isoattenuation compared to the surrounding liver parenchyma of approximately half the number of hemangiomas with diffuse enhancement during the portal venous phase on dynamic CT, a pattern also known as high flow hemangioma.…”

Section: Discussionmentioning

confidence: 99%

Hepatic Hemangiomas: Factors Associated with Pseudo Washout Sign on Gd-EOB-DTPA-enhanced MR Imaging

et al. 2016

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Purpose: Our study aim was to clarify the characteristics of hemangiomas with pseudo washout sign (PWS) by comparing their features with those of hemangiomas without PWS on gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging.Methods: We evaluated the features of hemangiomas on Gd-EOB-DTPA-enhanced MR imaging of 70 hepatic hemangiomas in 31 patients, investigating the presence of peripheral or central nodular enhancement, diffuse enhancement, and arterioportal shunt during the arterial phase, fill-in enhancement during the portal venous phase, and PWS, which is low signal intensity during the late phase. We visually assessed the intensity of contrast enhancement of the lesion during the arterial, portal venous, late, and hepatobiliary phases using a 4-grade scale and used the Fisher exact and Mann-Whitney U tests to compare hemangiomas with and without PWS.Results: We observed PWS in 33 (47%) of 70 hemangiomas, which were significantly smaller than the hemangiomas without PWS (17.4 mm « 20.3 versus 30.1 mm « 28.5; P = 0.005); more frequent diffuse enhancement in hemangiomas with PWS than those without (21.2% versus 2.7%; P = 0.026); and no significant differences in nodular enhancement (P = 0.231), arterioportal shunt (P = 0.403), or fill-in enhancement (P = 0.357) between hemangiomas with and without PWS. Visually determined grades of tumor contrast enhancement were significantly lower in hemangiomas with PWS during the portal venous (P = 0.007) and late (P < 0.001) phases.Conclusions: Small hemangiomas tend to decrease in signal intensity during the portal venous phase and show PWS during the late phase.

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“…In addition, a small number (n = 3) of lesions presented diffuse enhancement in the arterial phase on CEUS, which is an atypical perfusion pattern. Some authors thought that diffuse enhancement in the arterial phase was associated with tumor size (usually < 3 cm) (24), while others thought that dynamic contrast enhancement patterns were associated with size of the blood vessels rather than tumor size (25). E. Quaia suggested that diffuse enhancement on CEUS occurs more easily in cirrhotic patients (21).…”

Section: Discussionmentioning

confidence: 99%

A comparative study of contrast enhanced ultrasound and contrast enhanced magnetic resonance imaging for the detection and characterization of hepatic hemangiomas

Fang

Zhu

Huang

et al. 2015

BST

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Atypical radiographic findings in hepatic cavernous hemangioma: correlation with histologic features

Cited by 47 publications

References 0 publications

Hepatic cavernous hemangioma: sonographic patterns and speed of contrast enhancement on multiphase dynamic MR imaging.

Hepatic cavernous hemangioma: sonographic patterns and speed of contrast enhancement on multiphase dynamic MR imaging.

Hepatic Hemangiomas: Factors Associated with Pseudo Washout Sign on Gd-EOB-DTPA-enhanced MR Imaging

A comparative study of contrast enhanced ultrasound and contrast enhanced magnetic resonance imaging for the detection and characterization of hepatic hemangiomas

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