European Radiology

, Volume 26, Issue 1, pp 191–198 | Cite as

Enhancement patterns and pseudo-washout of hepatic haemangiomas on gadoxetate disodium-enhanced liver MRI

  • Bohyun Kim
  • Jae Ho ByunEmail author
  • Hyoung Jung Kim
  • Hyung Jin Won
  • So Yeon Kim
  • Yong Moon Shin
  • Pyo Nyun Kim



To compare the enhancement patterns and prevalence of pseudo-washout between rapidly and slowly enhancing hepatic haemangiomas on gadoxetate disodium-enhanced MRI in patients with chronic liver disease (CLD) and healthy liver (HL).


On gadoxetate disodium-enhanced MRI, the extent of intralesional arterial enhancement >50 % and ≤50 % of lesions was defined as rapid and slow enhancement, respectively. The enhancement patterns and presence of pseudo-washout during the portal venous phase (PVP) and transitional phase (TP) of 74 hepatic haemangiomas were retrospectively evaluated in the CLD and HL groups. Sequential changes of signal-to-noise ratio (SNR) were measured in unenhanced phase, PVP and TP.


Irrespective of hepatic health status, pseudo-washout in TP was significantly more common in the rapidly enhancing haemangiomas (p ≤ 0.026). In both groups, rapidly enhancing haemangiomas showed complete or progressive incomplete enhancement in PVP, which either lasted or transformed to pseudo-washout in TP, whereas slowly enhancing haemangiomas showed progressive incomplete enhancement in PVP and TP. SNR of hepatic parenchyma continued to rise until TP, whereas that of portal vein and haemangioma falls in TP.


Regardless of CLD, pseudo-washout in TP was more common in rapidly than in slowly enhancing haemangiomas, with enhancement patterns differing in the two subgroups.

Key Points

On gadoxetate disodium-enhanced MRI, some hepatic haemangiomas show pseudo-washout in transitional phase.

Regardless of chronic liver disease, pseudo-washout is significantly more common in rapidly enhancing haemangiomas.

Rapidly enhancing haemangiomas show complete or progressive incomplete enhancement or pseudo-washout in TP.

Slowly enhancing haemangiomas show progressive incomplete enhancement in portal venous phase and TP.


Haemangioma Pseudo-washout Gadoxetate disodium Magnetic resonance imaging Liver 



The authors would like to thank EunJu Kim, Clinical Scientist, Philips Healthcare Korea, for her consultation and assistance in preparing this paper.The scientific guarantor of this publication is Jae Ho Byun. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, cross sectional study, performed at one institution


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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Bohyun Kim
    • 1
    • 2
  • Jae Ho Byun
    • 1
    Email author
  • Hyoung Jung Kim
    • 1
  • Hyung Jin Won
    • 1
  • So Yeon Kim
    • 1
  • Yong Moon Shin
    • 1
  • Pyo Nyun Kim
    • 1
  1. 1.Department of Radiology and Research Institute of RadiologyUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulKorea
  2. 2.Department of RadiologyAjou University School of MedicineSuwonKorea

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