Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Gd-EOB-DTPA Enhanced MRI Features of Liver Hemangiomatosis Coexistent with GCH

Author(s): Dong Liu, Zhenguo Qiao, Lihua Xu, Fangfang Fu, Aihua Ye* and Chunhong Hu*

Volume 18, Issue 13, 2022

Published on: 11 August, 2022

Article ID: e020622205563 Pages: 6

DOI: 10.2174/1573405618666220602113223

Price: $65

Abstract

Objectives: This study aimed to clarify features of giant cavernous hemangioma (GCH) and liver hemangiomatosis, existing simultaneously on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI).

Method: A total of 17 patients with reported hepatic hemangiomatosis between 2015 and 2017 were identified retrospectively. All our patients underwent pre-contrast MRI, triphasic (atrial, portal, venous) Gd-EOB-DTPA dynamic enhancement and hepatobiliary phase (20 minutes delayed). The location, size, morphology and signal characteristics on T1-weighted (T1WI) and T2-weighted images (T2WI), and Gd-EOB-DTPA-enhanced MRI of liver hemangiomatosis were evaluated.

Results: Hemangiomatosis involved the liver adjacent to the edge of the GCH with no normal liver tissue found in 13 cases; in the other 4 patients, a small area of normal liver tissue separated GCH from hemangiomatosis was seen. On non-contrast MRI images, hemangionmatosis presented as numerous microcystic lesions, with low signal intensity on T1WI and high signal intensity on T2WI, compared with unaffected liver. After administration of Gd-EOB-DTPA, heterogeneous enhancement was presented in the arterial phase, during portal and venous phase imaging, becoming more homogeneous. 11 cases showed hypointensity in the hepatobiliary phase (6 cases with intratumor necrosis), and 6 cases showed hyper-intensity in the hepatobiliary phase with a remaining unfilled portion.

Conclusion: Hemangiomatosis is extremely rare in the liver adjacent to a GCH. MRI is of great diagnostic and clinical value for this kind of tumor according to the configuration, size, signal, and style of enhancement, but the final diagnosis depends on pathology. Gd-EOB-DTPA-enhanced MRI may help in diagnosing hemangiomatosis coexistent with GCH.

Keywords: Hepatic, hemangiomatosis, magnetic resonance imaging, gadolinium-ethoxybenzyl-diethylenetriamin-pentaacetic acid, diagnosis, imaging.

Graphical Abstract

[1]
Glick ZR, Frieden IJ, Garzon MC, Mully TW, Drolet BA. Diffuse neonatal hemangiomatosis: An evidence-based review of case reports in the literature. J Am Acad Dermatol 2012; 67(5): 898-903.
[http://dx.doi.org/10.1016/j.jaad.2012.01.018] [PMID: 22341467]
[2]
Ohnishi S, Miyagishima T, Nakagawa M, et al. Diffuse neonatal hemangiomatosis without cutaneous lesions in an adult--a case report. Angiology 2002; 53(2): 235-7.
[http://dx.doi.org/10.1177/000331970205300217] [PMID: 11952117]
[3]
Lopriore E, Markhorst DG. Diffuse neonatal haemangiomatosis: New views on diagnostic criteria and prognosis. Acta Paediatr 1999; 88(1): 93-7.
[http://dx.doi.org/10.1111/j.1651-2227.1999.tb01276.x] [PMID: 10090556]
[4]
Dotan M, Lorber A. Congestive heart failure with diffuse neonatal hemangiomatosis--case report and literature review. Acta Paediatr 2013; 102(5): e232-8.
[http://dx.doi.org/10.1111/apa.12184] [PMID: 23432737]
[5]
Tal R, Dotan M, Lorber A. Approach to haemangiomatosis causing congestive heart failure. Acta Paediatr 2016; 105(6): 600-4.
[http://dx.doi.org/10.1111/apa.13359] [PMID: 26859502]
[6]
Hammerstingl R, Huppertz A, Breuer J, et al. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: Comparison with intraoperative and histopathologic findings in focal liver lesions. Eur Radiol 2008; 18(3): 457-67.
[http://dx.doi.org/10.1007/s00330-007-0716-9] [PMID: 18058107]
[7]
Kühn JP, Hegenscheid K, Siegmund W, Froehlich CP, Hosten N, Puls R. Normal dynamic MRI enhancement patterns of the upper abdominal organs: Gadoxetic acid compared with gadobutrol. AJR Am J Roentgenol 2009; 193(5): 1318-23.
[http://dx.doi.org/10.2214/AJR.09.2412] [PMID: 19843748]
[8]
Tateyama A, Fukukura Y, Takumi K, et al. Gd-EOB-DTPA-enhanced magnetic resonance imaging features of hepatic hemangioma compared with enhanced computed tomography. World J Gastroenterol 2012; 18(43): 6269-76.
[http://dx.doi.org/10.3748/wjg.v18.i43.6269] [PMID: 23180948]
[9]
Jhaveri KS, Vlachou PA, Guindi M, et al. Association of hepatic hemangiomatosis with giant cavernous hemangioma in the adult population: Prevalence, imaging appearance, and relevance. AJR Am J Roentgenol 2011; 196(4): 809-15.
[http://dx.doi.org/10.2214/AJR.09.4143] [PMID: 21427329]
[10]
Moon WS, Yu HC, Lee JM, Kang MJ. Diffuse hepatic hemangiomatosis in an adult. J Korean Med Sci 2000; 15(4): 471-4.
[http://dx.doi.org/10.3346/jkms.2000.15.4.471] [PMID: 10983701]
[11]
Roque Ramos L, Coelho ML. Hepatic haemangiomatosis: Multinodular liver in an asymptomatic elderly man. BMJ Case Rep 2014; 2014(mar12 1): bcr2013202505.
[http://dx.doi.org/10.1136/bcr-2013-202505] [PMID: 24623542]
[12]
Vilgrain V, Boulos L, Vullierme MP, Denys A, Terris B, Menu Y. Imaging of atypical hemangiomas of the liver with pathologic correlation. Radiographics 2000; 20(2): 379-97.
[http://dx.doi.org/10.1148/radiographics.20.2.g00mc01379] [PMID: 10715338]
[13]
Shao RZ, Zhao DH, Li J. Treatment of infantile hemangioma by intralesional injection of propranolol combined with compound betame-thasone. Eur Rev Med Pharmacol Sci 2016; 20(4): 751-5.
[PMID: 26957280]
[14]
Ozakyol A, Kebapci M. Enhanced growth of hepatic hemangiomatosis in two adults after postmenopausal estrogen replacement therapy. Tohoku J Exp Med 2006; 210(3): 257-61.
[http://dx.doi.org/10.1620/tjem.210.257] [PMID: 17077603]
[15]
Feurle GE. Arteriovenous shunting and cholestasis in hepatic hemangiomatosis associated with metoclopramide. Gastroenterology 1990; 99(1): 258-62.
[http://dx.doi.org/10.1016/0016-5085(90)91256-6] [PMID: 2344931]
[16]
Maeda E, Akahane M, Watadani T, et al. Isolated hepatic hemangiomatosis in adults: Report of two cases and review of the literature. Eur J Radiol Extra 2007; 61(1): 9-14.
[http://dx.doi.org/10.1016/j.ejrex.2006.10.007]
[17]
Lehmann FS, Beglinger C, Schnabel K, Terracciano L. Progressive development of diffuse liver hemangiomatosis. J Hepatol 1999; 30(5): 951-4.
[http://dx.doi.org/10.1016/S0168-8278(99)80152-4] [PMID: 10365825]
[18]
Ringe KI, Husarik DB, Sirlin CB, Merkle EM. Gadoxetate disodium-enhanced MRI of the liver: Part 1, protocol optimization and lesion appearance in the noncirrhotic liver. AJR Am J Roentgenol 2010; 195(1): 13-28.
[http://dx.doi.org/10.2214/AJR.10.4392] [PMID: 20566794]
[19]
Ohkura Y, Hashimoto M, Lee S, Sasaki K, Matsuda M, Watanabe G. Right hepatectomy for giant cavernous hemangioma with diffuse hemangiomatosis around Glisson’s capsule. World J Gastroenterol 2014; 20(25): 8312-6.
[http://dx.doi.org/10.3748/wjg.v20.i25.8312] [PMID: 25009410]
[20]
Horton KM, Bluemke DA, Hruban RH, Soyer P, Fishman EKCT. CT and MR imaging of benign hepatic and biliary tumors. Radiographics 1999; 19(2): 431-51.
[http://dx.doi.org/10.1148/radiographics.19.2.g99mr04431] [PMID: 10194789]
[21]
Kim YK, Kim CS, Lee JM, Chung GH, Chon SB. Efficacy and safety of radiofrequency ablation of hepatocellular carcinoma in the hepatic dome with the CT-guided extrathoracic transhepatic approach. Eur J Radiol 2006; 60(1): 100-7.
[http://dx.doi.org/10.1016/j.ejrad.2006.05.002] [PMID: 16781835]
[22]
Seo JW, Kim SH, Kim AY, Jeong WK, Woo JY, Park WJ. Differentiating primary hepatic angiosarcomas from hemangiomatosis and epithelioid hemangioendotheliomas using gadoxetic acid-enhanced and diffusion-weighted MR imaging. Jpn J Radiol 2017; 35(11): 655-63.
[http://dx.doi.org/10.1007/s11604-017-0676-1] [PMID: 28879422]
[23]
Bioulac-Sage P, Laumonier H, Laurent C, Blanc JF, Balabaud C. Benign and malignant vascular tumors of the liver in adults. Semin Liver Dis 2008; 28(3): 302-14.
[http://dx.doi.org/10.1055/s-0028-1085098] [PMID: 18814083]
[24]
Chien CY, Hwang CC, Yeh CN, et al. Liver angiosarcoma, a rare liver malignancy, presented with intraabdominal bleeding due to rupture--a case report. World J Surg Oncol 2012; 10(1): 23.
[http://dx.doi.org/10.1186/1477-7819-10-23] [PMID: 22280556]
[25]
Buetow PC, Buck JL, Ros PR, Goodman ZD. Malignant vascular tumors of the liver: Radiologic-pathologic correlation. Radiographics 1994; 14(1): 153-66.
[http://dx.doi.org/10.1148/radiographics.14.1.8128048] [PMID: 8128048]
[26]
Koyama T, Fletcher JG, Johnson CD, Kuo MS, Notohara K, Burgart LJ. Primary hepatic angiosarcoma: Findings at CT and MR imaging. Radiology 2002; 222(3): 667-73.
[http://dx.doi.org/10.1148/radiol.2223010877] [PMID: 11867783]
[27]
Peterson MS, Baron RL, Rankin SC. Hepatic angiosarcoma: Findings on multiphasic contrast-enhanced helical CT do not mimic hepatic hemangioma. AJR Am J Roentgenol 2000; 175(1): 165-70.
[http://dx.doi.org/10.2214/ajr.175.1.1750165] [PMID: 10882268]
[28]
Bruegel M, Muenzel D, Waldt S, Specht K, Rummeny EJ. Hepatic angiosarcoma: Cross-sectional imaging findings in seven patients with emphasis on dynamic contrast-enhanced and diffusion-weighted MRI. Abdom Imaging 2013; 38(4): 745-54.
[http://dx.doi.org/10.1007/s00261-012-9967-2] [PMID: 23223833]
[29]
Mehrabi A, Kashfi A, Fonouni H, et al. Primary malignant hepatic epithelioid hemangioendothelioma: A comprehensive review of the literature with emphasis on the surgical therapy. Cancer 2006; 107(9): 2108-21.
[http://dx.doi.org/10.1002/cncr.22225] [PMID: 17019735]
[30]
Rademaker J, Widjaja A, Galanski M. Hepatic hemangiosarcoma: Imaging findings and differential diagnosis. Eur Radiol 2000; 10(1): 129-33.
[http://dx.doi.org/10.1007/s003300050018] [PMID: 10663729]
[31]
Bishop PR, Nowicki MJ, Parker PH. Radiological case of the month. Hepatic hemangiomatosis. Arch Pediatr Adolesc Med 2000; 154(7): 743-4.
[http://dx.doi.org/10.1001/archpedi.154.7.743] [PMID: 10891029]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy