Rapidly enhancing hepatic hemangiomas at MRI: Distinction from malignancies with T2-weighted images
Corresponding Author
Eric K. Outwater MD
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107Search for more papers by this authorKatsuyoshi Ito MD
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107
Search for more papers by this authorEvan Siegelman MD
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107
Search for more papers by this authorC. Edwin Martin MD
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107
Search for more papers by this authorManoj Bhatia MD
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107
Search for more papers by this authorDonald G. Mitchell MD
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107
Search for more papers by this authorCorresponding Author
Eric K. Outwater MD
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107Search for more papers by this authorKatsuyoshi Ito MD
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107
Search for more papers by this authorEvan Siegelman MD
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107
Search for more papers by this authorC. Edwin Martin MD
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107
Search for more papers by this authorManoj Bhatia MD
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107
Search for more papers by this authorDonald G. Mitchell MD
Department of Radiology, Thomas Jefferson University Hospital, 132 South Tenth Street, 1096 Main, Philadelphia, PA 19107
Search for more papers by this authorAbstract
The purpose of this study is to describe a subset of atypical hepatic hemangiomas that enhance rapidly and diffusely and to determine whether heavily T2-weighted images could distinguish between atypically enhancing liver hemangiomas and hypervascular malignancies. A retrospective search of MR records identified seven patients with liver hemangiomas that demonstrated diffuse early enhancement and 23 patients with biopsy-proven malignant liver lesions that were hypervascular on dynamic gadolinium-enhanced MR images. Quantitative analysis of signal intensity measurements was performed on the T2-weighted images, heavily T2-weighted (TE < 140), and dynamic gadolinium-enhanced images. Blinded reader comparison of the T2-weighted images and gadolinium-enhanced images was performed. Hypervascular hemangiomas enhanced to a greater degree than hypervascular malignant liver lesions on the early phase gadolinium-enhanced images. Perilesional parenchymal enhancement was demonstrated in five cases of rapidly enhancing hemangiomas. Signal intensity and contrast-to-noise ratios on the heavily T2-weighted images of the hemangiomas were significantly greater than that of the hypervascular malignant lesions (P < .05). Hemangiomas were differentiated from the hypervascular malignant liver lesions with high accuracy (97–100%) by three blinded readers based on the T2-weighted images. A subset of hemangiomas have atypical rapid diffuse enhancement on dynamic gadolinium-enhanced images. These atypical hemangiomas can be distinguished from hypervascular malignant liver lesions on T2-weighted MR images.
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