Imaging characteristics of hepatic epithelioid hemangioendothelioma / 中华肝胆外科杂志

ABSTRACT

Objective To investigate the imaging features of hepatic epithelioid hemangioendothelioma (EHE) and to improve the level of awareness of this disease.Methods A retrospective analysis was conducted on the CT and MRI findings and the clinical data of 16 patients with liver EHE.The diagnosis was made on specimens obtained by liver biopsy or with operation.Six patients received only CT,6 only MRI,4 both CT and MRI,and 4 with DWI sequence.Results 6 of 16 patients with hepatic EHE had a solitary tumor while the remaining 10 patients had multiple tumors.CT scanning on 10 patients showed a heterogeneous mass with low density.In 4 patients,there were small calcifications in the lesions.The lesions on MRI showed a heterogeneous mass with low signal in T1WI and high signal in T2WI and DWI.In 8 patients,during enhanced scanning,the intrahepatic vein and its branches terminated at the edge of the tumor to form the lollipop sign. On the arterial phase lesions with a diameter ＞ 3 cm showed a centripetal enhancement pattern,which is similar to that of a haemangioma.Lesions with a diameter ＜ 3 cm showed ring enhancement and continuous annular enhancement in the portal venous phase and in the delayed phase.The best observation period for the number of lesions was in the arterial phase.Conclusion Hepatic EHE had certain distinct characteristics on CT and MRI,e.g.the lollipop sign,lesions with small calcification,lesions with a diameter ＞ 3 cm with a centripetal enhancement pattern,and lesions with a diameter ＜ 3 cm with continuous ring enhancement on CT scanning.These radiological features help in the diagnosis of the disease.