Abstract
Purpose: To evaluate the MRI findings of retroperitoneal low-flow vascular malformations (RLVMs) correlated with histopathological findings. Methods: Two radiologists reviewed the MRI findings of 4 RLVMs (3 with capillary malformations and 1 with a venous malformation). First, they evaluated the visibility, signal intensities, and signal homogeneity of each lesion on non-fat-suppressed breath-hold T2-weighted single-shot fast spin-echo (non-FS SSFSE) images and fat-suppressed T2-weighted fast spin-echo (FS T2-weighted FSE) images. Second, the kinetic patterns and the internal enhancement patterns were analyzed for each lesion on multi-phasic contrast-enhanced (CE) images. After these image analyses, the MRI findings were correlated with the histopathological findings. Result: Histopathologically, the 4 RLVMs did not exhibit remarkable degeneration and were present in the retroperitoneal fat tissue without clear capsules. On the non-FS SSFSE images, 3 of the 4 RLVMs could not be discriminated from the surrounding retroperitoneal fat tissue (invisible), and the remaining lesion was barely visible with an indistinct margin. On the FS T2-weighted FSE images, however, all the RLVMs were clearly visualized as homogeneous high-signal intensities. On the multi-phasic CE images, all the capillary malformations exhibited fast enhancement, while a venous malformation showed slow enhancement. Furthermore, the RLVMs tended to exhibit a centripetal filling pattern. Conclusion: The RLVMs blended in with the surrounding retroperitoneal fat tissue on non-FS SSFSE images, like phantoms, whereas they were clearly visualized on FS T2-weighted FSE images. On multi-phasic CE images, the RLVMs tended to exhibit a centripetal filling pattern. These imaging features may be useful diagnostic clues for RLVMs.
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References
Mulliken JB, Glowacki J (1982) Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 69:412–422
Jackson IT, Carreño R, Potparic Z, et al. (1993) Hemangiomas, vascular malformations, and lymphovenous malformations: classification and methods of treatment. Plast Reconstr Surg 91:1216–1230
Enjolras O (1997) Classification and management of the various superficial vascular anomalies: hemangiomas and vascular malformations. J Dermatol 24:701–710
Flors L, Leiva-Salinas C, Maqed IM, et al. (2011) MR imaging of soft-tissue vascular malformations: diagnosis, classification, and therapy follow-up. Radiographics 31:1321–1340
Moukaddam H, Pollak J, Haims AH (2009) MRI characteristics and classification of peripheral vascular malformations and tumors. Skeletal Radiol 38:535–547
Lowe LH, Marchant TC, Rivard DC, Scherbel AJ (2012) Vascular malformations: classification and terminology the radiologist needs to know. Semin Roentgenol 47:106–117
Donnelly LF, Adams DM, Bisset GS 3rd (2000) Vascular malformations and hemangiomas: a practical approach in a multidisciplinary clinic. AJR Am J Roentgenol 174:597–608
van Rijswijk CS, van der Linden E, van der Woude HJ, et al. (2002) Value of dynamic contrast-enhanced MR imaging in diagnosing and classifying peripheral vascular malformations. AJR Am J Roentgenol 178:1181–1187
Goodwin RW, O’Donnell P, Saifuddin A (2007) MRI appearances of common benign soft-tissue tumours. Clin Radiol 62:843–853
Hassanein AH, Mulliken JB, Fishman SJ, Greene AK (2011) Evaluation of terminology for vascular anomalies in current literature. Plast Reconstr Surg 127:347–351
Vilanova JC, Barceló J, Smirniotopoulos JG, et al. (2004) Hemangioma from head to toe: MR imaging with pathologic correlation. Radiographics 24:367–385
Meyer JS, Hoffer FA, Barnes PD, Mulloken JB (1991) Biological classification of soft-tissue vascular anomalies: MR correlation. AJR Am J Roentgenol 157:559–564
Hyodoh H, Hori M, Akiba H, et al. (2005) Peripheral vascular malformations: imaging, treatment approaches, and therapeutic issues. Radiographics 25(Suppl 1):S159–S171
Morris EA, Comstock CE, Lee CH, et al. (2013) ACR BI-RADS® magnetic resonance imaging. In: ACR BI-RADS® Atlas, breast imaging reporting and data system. Reston: American College of Radiology
Igarashi J, Hanazaki K (1998) Retroperitoneal venous hemangioma. Am J Gastroenterol 93:2292–2293
Rha SE, Byun JY, Jung SE, et al. (2003) Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics 23:29–43
Nishino M, Hayakawa K, Minami M, et al. (2003) Primary retroperitoneal neoplasms: CT and MR imaging findings with anatomic and pathologic diagnostic clues. Radiographics 23:45–57
Blake MA, Kalra MK, Maher MM, et al. (2004) Pheochromocytoma: an imaging chameleon. Radiographics 24:S87–S99
Elsayes KM, Narra VR, Leyendecker JR, et al. (2005) MRI of adrenal and extraadrenal pheochromocytoma. AJR Am J Roentgenol 184:860–867
Lane RH, Stephens DH, Reiman HM (1989) Primary retroperitoneal neoplasms: CT findings in 90 cases with clinical and pathologic correlation. AJR Am J Roentgenol 152:83–89
Elsayes KM, Staveteig PT, Narra VR, et al. (2007) Retroperitoneal masses: magnetic resonance imaging findings with pathologic correlation. Curr Probl Diagn Radiol 36:97–106
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Akita, H., Yamada, Y., Ito, Y. et al. Retroperitoneal low-flow vascular malformations: characteristic MRI findings correlated with histopathological findings. Abdom Imaging 40, 1713–1720 (2015). https://doi.org/10.1007/s00261-014-0319-2
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DOI: https://doi.org/10.1007/s00261-014-0319-2