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- Title
CT and MRI features of hepatic epithelioid haemangioendothelioma: a multi-institutional retrospective analysis of 15 cases and a literature review.
- Authors
Luo, Lianmei; Cai, Zeyu; Zeng, Sihui; Wang, Lizhu; Kang, Zhuang; Yang, Ning; Zhang, Yaqin
- Abstract
Objective: To improve the current imaging understanding of MRI or CT for hepatic epithelioid haemangioendothelioma (HEHE) to aid in its successful preoperative diagnosis. Methods: The imaging features of 15 patients (median age 38.6, range 20–71; 7 M/8 F) from eight institutions with pathologically confirmed HEHE were retrospectively analysed. Additionally, the CT/MR imaging features of 180 patients in 15 literature publications were collected, analysed and compared with our case series. Results: Fifteen patients underwent CT and MRI (n = 2), CT (n = 9) or MR (n = 8) scans. A total of 92.9% (13/14) of the patients were initially diagnosed with other lesions on imaging. A total of 86.7% (13/15) were multifocal. Nodules (11/15, 73.3%) were predominantly peripheral in distribution (12/15, 80.0%). Some cases were associated with hepatic capsular retraction (13/15, 86.7%), "target signs" (8/15, 53.3%) and "lollipop signs" (5/15, 33.3%). Peripheral enhancement of various shapes in the early phase with a progressive centripetal filling was the most common pattern of enhancement (12/15, 80.0%). Abnormal vascularity was seen in 50.7% (6/15) of the patients. Suspicious tumour thromboses in the inferior vena cava were seen in 3 (20.0%) of the patients. Two of the 15 patients (13.3%) had a history of smoking. Conclusions: HEHEs have common distinctive features, including multifocal lesions that are predominantly peripheral, "target signs", "lollipop signs", hepatic capsular retraction and peripheral enhancement of various shapes in the early phase with progressive centripetal filling. Additional aggressive imaging features that may be valuable clues to the diagnosis can be identified by CT or MRI. Key points: "Target signs" and "lollipop signs" should be recognised in imaging evaluation, raising the possibility of HEHE in the differential diagnosis. Abnormal blood vessels in tumours may have implications for imaging diagnosis. When HEHE is suspected, radiologists should be aware of tumour thrombi in the vena cava. HEHEs always present with a peripheral enhancement of various shapes with centripetal progressive filling.
- Subjects
ANGIOSARCOMA; VENA cava inferior; MAGNETIC resonance imaging; LITERATURE reviews; VENAE cavae
- Publication
Insights into Imaging, 2023, Vol 14, Issue 1, p1
- ISSN
1869-4101
- Publication type
Article
- DOI
10.1186/s13244-022-01344-y