Paolantonio Pasquale, Laghi Andrea, Vanzulli Angelo, Grazioli Luigi, Morana Gianni, Ragozzino Alfonso, Colagrande Stefano
Department of Radiology, San Giovanni-Addolorata Hospital, Rome, Italy.
J Magn Reson Imaging. 2014 Sep;40(3):552-8. doi: 10.1002/jmri.24391. Epub 2013 Nov 13.
To investigate magnetic resonance imaging (MRI) characteristics of hepatic epithelioid hemangionendothelioma (HEH).
The study was exempted from formal Ethics Committee approval due to its retrospective and noninvasive nature. Eleven patients with histology-proven HEH were collected from six different institutions in a 5-year time period. In all patients a contrast-enhanced MR study was available. Two experienced reviewers in consensus retrospectively noted potential MR findings of HEH. Reviewers separately analyzed morphological findings, tumor signal intensity, HEH contrast enhancement pattern, and tumor appearance on hepatobiliary phase and diffusion-weighted imaging (DWI). The frequency of various findings was calculated.
The most frequent presentation was a peripheral distribution of the lesions (72.7%), target appearance on T2-weighted images (63.6%), low signal intensity on T1-weighted images (63.6%), ring or target-like enhancement at dynamic study (63.6%), and coalescence of nodules and capsular retraction (45.4%). Lack of hepatobiliary enhancement (5/8 patients) or "entrapment" hepatobiliary enhancement (3/8 patients) as well as target appearance at DWI (5/6 patients) was also observed in our series.
Although quite variable imaging appearances were seen, a target appearance on the T2-weighted image, ring or target enhancement at dynamic study, lack of enhancement or "entrapment" at hepatobiliary phase, and target appearance on DWI are frequent findings of HEH.
探讨肝上皮样血管内皮瘤（HEH）的磁共振成像（MRI）特征。
由于本研究具有回顾性和非侵入性，因此无需获得伦理委员会的正式批准。在5年时间内，从6个不同机构收集了11例经组织学证实的HEH患者。所有患者均进行了对比增强磁共振检查。两名经验丰富的审阅者达成共识，回顾性记录HEH的潜在磁共振表现。审阅者分别分析形态学表现、肿瘤信号强度、HEH对比增强模式以及肝胆期和扩散加权成像（DWI）上的肿瘤表现。计算各种表现出现的频率。
最常见的表现为病变呈周边分布（72.7%）、T2加权像上呈靶征（63.6%）、T1加权像上呈低信号强度（63.6%）、动态研究时呈环形或靶样强化（63.6%）以及结节融合和包膜回缩（45.4%）。在我们的系列研究中还观察到肝胆期无强化（5/8例患者）或“包绕”性肝胆期强化（3/8例患者）以及DWI上呈靶征（5/6例患者）。
尽管观察到相当多变的影像学表现，但T2加权像上呈靶征、动态研究时呈环形或靶样强化、肝胆期无强化或“包绕”以及DWI上呈靶征是HEH的常见表现。
