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Differentiating primary hepatic angiosarcomas from hemangiomatosis and epithelioid hemangioendotheliomas using gadoxetic acid-enhanced and diffusion-weighted MR imaging

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Abstract

Objectives

To assess the value of gadoxetic acid-enhanced and diffusion-weighted (DW) magnetic resonance (MR) imaging for differentiating primary hepatic angiosarcomas from hemangiomatosis and epithelioid hemangioendotheliomas (EHEs).

Methods

We reviewed MR images of seven patients with pathologically determined hepatic angiosarcomas, 11 patients with hemangiomatosis, and five patients with EHEs. Two radiologists assessed morphologic features, signal intensity (SI), enhancement patterns, and the presence of diffusion restriction by consensus and compared between angiosarcoma vs hemangiomatosis and angiosarcoma vs EHEs.

Results

Angiosarcomas more frequently showed mixed well- and ill-defined margins (6, 85.7%), mixed strong and intermediate-high SI (5, 71.4%) on T2-weighted images, mixed peripheral and/or central nodular and rim and/or target enhancement (5, 71.4%), and mixed presence and absence of diffusion restriction (7, 100%) compared with hemangiomatosis and EHEs (P < 0.05). The overall survival rate in patients with angiosarcomas was 42.9% at 3 months and 14.3% at 14 months, whereas all patients with EHEs were alive during the follow-up period from 4 to 43 months (P = 0.002).

Conclusion

Gadoxetic acid-enhanced and DW MR imaging may help differentiate primary hepatic angiosarcomas with hemangioma-like appearance, EHE-like appearance, or both; and poor prognosis from hemangiomatosis and EHEs.

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Abbreviations

EHE:

Epithelioid hemangioendothelioma

DW:

Diffusion-weighted

MR:

Magnetic resonance

SI:

Signal intensity

CSF:

Cerebrospinal fluid

ADC:

Apparent diffusion coefficient

ROI:

Region of interest

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Authors and Affiliations

  1. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 135-710, Republic of Korea

    Seong Hyun Kim, Ah Yeong Kim & Woo Kyoung Jeong

  2. Department of Radiology, Ilsan Paik Hospital, Inje University School of Medicine, 170 Juhwa-ro, Ilsanseo-gu, Goyang, 10380, Republic of Korea

    Jung Wook Seo & Won Jeong Park

  3. Department of Radiology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, 948-1 Daerim 1-Dong, Yeongdeungpo-Gu, Seoul, Republic of Korea

    Ji Young Woo

Authors
  1. Jung Wook Seo
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  2. Seong Hyun Kim
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  3. Ah Yeong Kim
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Correspondence to Seong Hyun Kim.

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Seo, J.W., Kim, S.H., Kim, A.Y. et al. Differentiating primary hepatic angiosarcomas from hemangiomatosis and epithelioid hemangioendotheliomas using gadoxetic acid-enhanced and diffusion-weighted MR imaging. Jpn J Radiol 35, 655–663 (2017). https://doi.org/10.1007/s11604-017-0676-1

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  • DOI: https://doi.org/10.1007/s11604-017-0676-1

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