Kim Bohyun, Byun Jae Ho, Kim Hyoung Jung, Won Hyung Jin, Kim So Yeon, Shin Yong Moon, Kim Pyo Nyun
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-gil 86, Songpa-Gu, Seoul, 138-736, Korea.
Department of Radiology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380, Korea.
Eur Radiol. 2016 Jan;26(1):191-8. doi: 10.1007/s00330-015-3798-9. Epub 2015 May 2.
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.
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.
比较慢性肝病（CLD）患者和健康肝脏（HL）患者在钆塞酸二钠增强MRI上快速强化和缓慢强化的肝血管瘤之间的强化模式及伪廓清发生率。
在钆塞酸二钠增强MRI上，病灶内动脉期强化程度>50%和≤50%分别定义为快速强化和缓慢强化。回顾性评估CLD组和HL组中74个肝血管瘤在门静脉期（PVP）和移行期（TP）的强化模式及伪廓清情况。在平扫期、PVP和TP期测量信噪比（SNR）的连续变化。
无论肝脏健康状况如何，快速强化的血管瘤在TP期出现伪廓清的情况明显更常见（p≤0.026）。在两组中，快速强化的血管瘤在PVP期表现为完全强化或进行性不完全强化，在TP期持续或转变为伪廓清，而缓慢强化的血管瘤在PVP期和TP期均表现为进行性不完全强化。肝实质的SNR持续上升直至TP期，而门静脉和血管瘤的SNR在TP期下降。
无论是否存在CLD，快速强化的血管瘤在TP期出现伪廓清的情况比缓慢强化的血管瘤更常见，且两个亚组的强化模式不同。
在钆塞酸二钠增强MRI上，一些肝血管瘤在移行期出现伪廓清。无论是否患有慢性肝病，快速强化的血管瘤中伪廓清明显更常见。快速强化的血管瘤在TP期表现为完全强化、进行性不完全强化或伪廓清。缓慢强化的血管瘤在门静脉期和TP期表现为进行性不完全强化。
