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Ultrasound findings of hepatic epithelioid hemangioendothelioma: comparison with other malignant hepatic tumors

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Abstract

Purpose

To investigate and compare the ultrasonic features of hepatic epithelioid hemangioendothelioma (HEHE) and other common hepatic malignancies, such as hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC) and hepatic metastatic tumor (HMT).

Methods

A total of 37 patients with pathologically proven HEHE, 37 HCC cases, 37 ICC cases, and 37 HMT cases were enrolled from single hospital. The clinical characteristics and ultrasonic features of all cases were summarized and statistically analyzed.

Results

There were significant differences in sex and age between the HEHE group and other three groups (P < 0.001). The probability of HEHE infection with hepatitis B virus was lower than that of HCC and ICC groups (P < 0.05). The probability of elevated serum tumor markers in HEHE was significantly lower than that in the other three groups (P < 0.05). On conventional ultrasound (CUS), the probability of multiple lesions in HEHE was significantly higher than that in the other three groups (P < 0.05). On contrast-enhanced ultrasound (CEUS), the time to wash out in HEHE was significantly shorter than that of the other three groups (P < 0.001). The proportion of synchronous or slow enhancement in HEHE was significantly higher than that of the other three groups (P < 0.001). The proportion of HEHE with iso- or hypo-enhancement was significantly higher than in HCC and HMT groups (P < 0.05).

Conclusion

HEHE mainly performed multiple hypoechoic lesions on CUS and displayed greater odds of synchronous enhancement in arterial phase, iso- or hypo-enhancement in peak time and wash out more quickly on CEUS, which allowed for differentiation from other common malignant tumors.

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Acknowledgements

This study was supported by the Natural Science Foundation Project of Shanghai “Science and Technology Innovation Action Plan” (Grant No. 20ZR1452800) and National Natural Science Foundation of China (Grant No. 82272013).

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Author notes

  1. Yadan Xu, Kailing Chen, Qi Zhang have contributed equally to this work.

Authors and Affiliations

  1. Department of Ultrasound, Zhongshan Hospital, Fudan University, 180th Fengling Rd, Xuhui District, Shanghai, 200032, China

    Yadan Xu, Kailing Chen, Qi Zhang, Yang Tang, Benhua Xu, Xi Wang, Chaolun Li, Hantao Wang & Wenping Wang

  2. Institute of Ultrasound in Medicine and Engineering, Fudan University, 180th Fengling Rd, Xuhui District, Shanghai, 200032, China

    Yadan Xu & Wenping Wang

  3. Shanghai Institute of Medical Imaging, 180th Fengling Rd, Xuhui District, Shanghai, 200032, China

    Xi Wang, Hantao Wang & Wenping Wang

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  1. Yadan Xu
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Correspondence to Wenping Wang.

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Xu, Y., Chen, K., Zhang, Q. et al. Ultrasound findings of hepatic epithelioid hemangioendothelioma: comparison with other malignant hepatic tumors. Abdom Radiol 49, 762–773 (2024). https://doi.org/10.1007/s00261-023-04126-2

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