Distinction of Hemangiomas from Hepatic Tumors with Delayed Enhancement by Incremental Dynamic CT

Ito, Katsuyoshi; Honjo, Kazumitsu; Matsumoto, Tsuneo; Tanaka, Rikuo; Nakada, Taishi; Nakanishi, Takashi

doi:10.1097/00004728-199207000-00014

Cited by 10 publications

(3 citation statements)

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“…However, this sign is not meant to be used alone but in conjunction with other MR appearances in hemangiomas and metastases. Therefore, it would be important to carefully review other imaging findings such as the enhancement pattern at AP (dense, spotty peripheral enhancement in hemangioma vs. circumferential bead‐ and band‐like peripheral enhancement) (29) and the characteristic findings of T2‐weighted sequences (definite high signal in both moderately and heavily T2‐weighted images in hemangiomas vs. higher signal on moderate T2‐weighted images than on heavily T2 weighted images in metastases) (30) for a more accurate diagnosis at Gd‐EOB‐DTPA‐enhanced MRI.…”

Section: Discussionmentioning

confidence: 99%

Peripheral low intensity sign in hepatic hemangioma: Diagnostic pitfall in hepatobiliary phase of Gd‐EOB‐DTPA‐enhanced MRI of the liver

Tamada¹,

Ito²,

Ueki³

et al. 2011

Magnetic Resonance Imaging

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Purpose: To describe the presence of ''peripheral low intensity sign'' in hepatic hemangioma in the hepatobiliary phase (HP) of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and to compare the frequency of this sign between hepatic hemangiomas and hepatic metastases. Materials and Methods:The Institutional Review Board approved this study and waived the requirement for informed consent. Sixty-four patients with 51 hepatic hemangiomas (n ¼ 31 patients) and with 58 hepatic metastases (n ¼ 33 patients) underwent Gd-EOB-DTPA-enhanced MRI. In all hepatic hemangiomas, 41 lesions were the typical type and 10 were the high flow type. HP images were qualitatively evaluated for the frequency of peripheral low intensity sign in hepatic hemangiomas and hepatic metastases using a four-point scale. Statistical evaluations were performed with a Mann-Whitney U-test.Results: Peripheral low intensity signs were demonstrated in 24 (47%) of 51 hepatic hemangiomas, while they were seen in 27 (47%) of 58 hepatic metastases. There was no significant difference in the mean visual score of peripheral low intensity sign between all hepatic hemangiomas (0.84 6 1.03) and hepatic metastases (0.76 6 0.92). The mean visual score of peripheral low intensity sign in typical hemangiomas (1.02 6 1.06) was significantly higher than that in high flow hemangiomas (0.10 6 0.32) (P ¼ 0.008). Conclusion:Peripheral low intensity sign is not specific for malignant tumors, and can be seen even in hepatic hemangiomas on HP of Gd-EOB-DTPA-enhanced MRI.

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Section: Discussionmentioning

confidence: 99%

Peripheral low intensity sign in hepatic hemangioma: Diagnostic pitfall in hepatobiliary phase of Gd‐EOB‐DTPA‐enhanced MRI of the liver

Tamada¹,

Ito²,

Ueki³

et al. 2011

Magnetic Resonance Imaging

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“…Therefore, it is important to characterize the appearance of hemangiomas on two-phase CT scans, which has become a popular study for the liver. Although previous papers have reported radiologic finding of hepatic tumor with spiral CT [2] and have defined the characterization of hepatic hemangioma with incremental dynamic CT [3][4][5], few of the papers have evaluated contrast-enhancement patterns of hepatic hemangioma with the arterial and portal venous phases of spiral CT.…”

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confidence: 99%

Hepatic Hemangioma: Contrast-Enhancement Pattern during the Arterial and Portal Venous Phases of Spiral CT

et al. 1999

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The objective of the present study was to evaluate contrast-enhancement patterns of hepatic hemangioma according to size during hepatic arterial (30-s delay) and portal venous (65-s delay) phases of spiral computed tomography (CT). During a 10-month-period, 73 patients with 118 hemangiomas underwent two-phase spiral CT examination. The enhancement patterns of tumors were divided into four types based on the attenuation of surrounding liver parenchyma: peripherally nodular high, uniform high, iso, and low. The diameter of the tumors were <10 mm (n = 39), 11-20 mm (n = 33), and >21 mm (n = 46). Overall, the most common enhancement patterns of hemangioma were peripherally nodular high (66/118, 55. 9%) during the arterial and portal venous phases. The second most common contrast-enhancement patterns of hemangioma were uniform high (15/118, 12.7%) during the arterial and portal venous phases. In tumors smaller than 20 mm, 11 (9.3%) had low-low attenuation and two (1.7%) had iso-low attenuation during the arterial and portal venous phases, respectively. In conclusion, at two-phase spiral CT, the most common contrast-enhancement patterns of hemangioma are peripherally nodular high and/or uniform high during the arterial and portal venous phases. However, hemangiomas smaller than 2 cm may have atypical enhancing patterns including low and iso-attenuation.

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“…Multiphasic contrast-enhanced dynamic computed tomography (CT) has been widely used for the detection and characterization of liver lesions as well as for the surveillance of chronic liver diseases [1]. Generally, this technique involves three-phase CT imaging, including arterial, portal, and equilibrium phases, in addition to precontrast CT.…”

Section: Introductionmentioning

confidence: 99%

Dual-Source Contrast-Enhanced Multiphasic CT of the Liver Using Low Voltage (70 kVp): Feasibility of a Reduced Radiation Dose and a 50% of Contrast Dose

Miyoshi,

Tanabe,

Ihara

et al. 2023

Tomography

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This study investigated the feasibility of both a reduced radiation dose and a 50% of contrast dose in multiphasic CT of the liver with a 70 kVp protocol compared with a standard-tube-voltage protocol derived from dual-energy (DE) CT (blended DE protocol) with a full-dose contrast-agents in the same patient group. This study included 46 patients who underwent multiphasic contrast-enhanced dynamic CT of the liver with both a 70 kVp and a blended DE protocols. For quantitative analysis, median CT values for the liver, aorta, and portal vein, as well as signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), were measured and calculated. In addition, as a qualitative analysis, the contrast effect and overall image quality of the abdominal organs were evaluated on a five-point scale. CNR and SNR of the hepatic parenchyma were not significantly different between the 70kV protocol and the Blended DE protocol in all phases. The 70 kVp protocol showed significantly better image quality compared with the blended DE protocol in the arterial phase (p = 0.035) and the equilibrium layer phase (p = 0.016). A 70 kVp CT protocol in combination with a reduced radiation dose and half-dose iodine load is feasible for multiphasic dynamic CT of the liver by maintaining the contrast enhancement effects and image quality in comparison with the blended DE CT protocol.

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Distinction of Hemangiomas from Hepatic Tumors with Delayed Enhancement by Incremental Dynamic CT

Cited by 10 publications

References 0 publications

Peripheral low intensity sign in hepatic hemangioma: Diagnostic pitfall in hepatobiliary phase of Gd‐EOB‐DTPA‐enhanced MRI of the liver

Peripheral low intensity sign in hepatic hemangioma: Diagnostic pitfall in hepatobiliary phase of Gd‐EOB‐DTPA‐enhanced MRI of the liver

Hepatic Hemangioma: Contrast-Enhancement Pattern during the Arterial and Portal Venous Phases of Spiral CT

Dual-Source Contrast-Enhanced Multiphasic CT of the Liver Using Low Voltage (70 kVp): Feasibility of a Reduced Radiation Dose and a 50% of Contrast Dose

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