CT and MRI Findings and Follow-up Changes of Infantile Hepatic Hemangioendothelioma / 中国医学影像学杂志

ABSTRACT

Purpose To analyze the CT and MRI findings as well as follow-up changes of infantile hepatic hemangio-endothelioma (IHE),so as to provide basis for guiding the clinical establishment of therapeutic protocols.Materials and Methods The clinical data of 21 infants with IHE were analyzed retrospectively,including the imageological manifestations in initial diagnosis and during follow-up.Among the infants,3 received non-enhanced and enhanced scan of both CT and MRI,13 received non-enhanced and enhanced scan of CT only,while 5 received non-enhanced and enhanced scan of MRI only.All infants received ultrasonic examination.Results In non-enhanced CT scan,the tumor was marked by multiple or single intrahepatic low-density nidus with clear boundary,while non-enhanced MRI showed low T1WI signal and high T2WI signal.Enhanced scan of single IHE in arterial phase indicated notable nodular,streak-like and annular enhancement of the edge,while that in delayed period suggested a characteristic of progressive enhancement of tumor from periphery to center.There was not enhancement in necrotic zone in the center of large nidi all the time,while streak-like calcification nidi were found in partial nidi.Obvious whole-tumor enhancement was found in most nodes in the multiple nodular IHE,while moderate enhancement in partial nodes.The enhancement in each enhanced period decreased gradually,and most nidi in delayed period showed slightly high-density or isopycnic shadow.3 infants were misdiagnosed with hepatoblastoma and received surgical resection,but none had recurrence during postoperative ultrasonic follow-up.The rest infants were treated with oral administration of Propranolol and then followed up,and the follow-up results showed that most nidi shrunk to different extent while partial nidi disappeared completely.Conclusion IHE is marked by multiple nidi or single nidus,and the characteristic manifestations of CT and MRI are beneficial to promoting the accuracy rate of diagnosis of IHE.Tumor may shrink spontaneously or disappear if Propranolol is orally administered in treatment of IHE.