Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Abdom Radiol (NY). 2019 Aug;44(8):2781-2787. doi: 10.1007/s00261-019-02043-x.
To report imaging and pathologic features of five pathologically proven anastomosing hemangiomas of the liver (AHL).
A retrospective review for AHL was conducted using our institutional database from 6/2004 to 3/2018. Histology proven AHL with radiologic imaging available for review were included. A total of five patients who met our criteria were identified from our institutional database. Computed tomography, ultrasound, and magnetic resonance imaging findings, including location, size, attenuation/signal intensity, enhancement characteristics, and additional imaging data were reviewed. The clinical and pathological data were also reviewed.
The imaging characteristics of AHL are variable, but features such as peripheral or diffuse hyperintensity on diffusion weighted imaging, arterial hyperenhancement without globular interrupted enhancement, and persistent enhancement without complete filling in the delayed phases were more characteristic of AHL. Imaging also demonstrated a lack of aggressive features.
AHL present a diagnostic dilemma as they can mimic more malignant lesions, such as angiosarcoma, both on imaging and at pathology. While the imaging characteristics of AHL are variable, there are some features which can help distinguish AHL from other liver lesions. When the diagnosis of anastomosing hemangioma is known, the management of choice is primarily surveillance, as intervention can cause unnecessary morbidity, and no degeneration to malignancy has been identified to date.
报告 5 例经病理证实的吻合性肝血管瘤（AHL）的影像学和病理学特征。
对 2004 年 6 月至 2018 年 3 月使用我们机构数据库进行 AHL 的回顾性研究。纳入具有放射影像学检查结果且经组织学证实的 AHL。从我们的机构数据库中确定了符合我们标准的 5 名患者。回顾了计算机断层扫描、超声和磁共振成像的发现，包括位置、大小、衰减/信号强度、增强特征和其他成像数据。还回顾了临床和病理数据。
AHL 的影像学特征是可变的，但弥散加权成像上的外周或弥漫性高信号、动脉期强化无球形中断强化、延迟期持续强化而无完全填充等特征更具 AHL 特征。影像学还显示缺乏侵袭性特征。
AHL 在影像学和病理学上可模拟更恶性的病变，如血管肉瘤，这给诊断带来了困难。虽然 AHL 的影像学特征是可变的，但有一些特征可以帮助将 AHL 与其他肝病变区分开来。当已知诊断为吻合性肝血管瘤时，主要的治疗选择是监测，因为干预可能会导致不必要的发病率，而且迄今为止尚未发现从良性向恶性的转变。
