Zhang Jingwen, Cai Jianming, Yan Cheng, Gao Mingzi, Han Jing, Zhang Mingxin, Yu Hailong, Zhang Mengmeng, Liu Changchun, Dong Jinghui, Zhao Liqin
Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China.
Abdom Radiol (NY). 2025 Mar;50(3):1189-1197. doi: 10.1007/s00261-024-04592-2. Epub 2024 Sep 21.
To investigate the magnetic resonance imaging (MRI) and clinicopathological features of primary hepatic angiosarcoma (PHA) and enhance preoperative diagnosis.
MRI and clinicopathological information of 12 cases proved PHA were reviewed. Summarize the MRI characteristics of PHA combined with literature reviews.
Among 12 cases (6 males and 6 females; age range, 23-70 years; mean, 53.3 years), one presented as a large mass, two as a diffuse infiltrating tumor, and nine as a mixed pattern of large masses with multiple nodules, all involving both lobes of the liver and ranging from 0.1 cm to 11 cm in diameter. A total of 63 lesions were analyzed, including 21 masses and 42 nodules. 13 masses (61.9%) demonstrated intratumoral hemorrhage. 18 masses (85.7%) demonstrated heterogeneous patchy, ring-shaped, septate, or irregular shaped enhancing foci on late arterial phase (LAP). On dynamic contrast-enhanced MRI (DCE-MRI), 14 masses (66.7%) showed a centripetal or centrifugal pattern of incomplete progressive enhancement. 6 nodules (14.3%) appeared intratumoral hemorrhage. 31 nodules (73.8%) showed no enhancing foci on LAP images and 27 nodules (64.3%) showed enhancement pattern of complete filling, either centripetal or centrifugal pattern. Moreover, 12 cases (100%) exhibited prominent vessels within or adjacent to at least one lesion.
PHA exhibits diverse appearances on MRI. Typical MRI signs include multifoci with intratumoral hemorrhage, prominent vessels within or adjacent to the foci, as well as varied degrees of progressive enhancement with incomplete filling in dominant masses of PHA.
探讨原发性肝血管肉瘤（PHA）的磁共振成像（MRI）及临床病理特征，以提高术前诊断水平。
回顾12例经病理证实的PHA患者的MRI及临床病理资料。结合文献复习总结PHA的MRI特征。
12例患者（男6例，女6例；年龄范围23 - 70岁，平均53.3岁）中，1例表现为巨大肿块，2例为弥漫浸润性肿瘤，9例为巨大肿块伴多发结节的混合模式，均累及肝脏两叶，直径0.1 cm至11 cm。共分析63个病灶，包括21个肿块和42个结节。13个肿块（61.9%）显示瘤内出血。18个肿块（85.7%）在动脉晚期（LAP）表现为不均匀斑片状、环形、分隔状或不规则形强化灶。在动态对比增强MRI（DCE - MRI）上，14个肿块（66.7%）表现为向心性或离心性不完全渐进性强化模式。6个结节（14.3%）出现瘤内出血。31个结节（73.8%）在LAP图像上无强化灶，27个结节（64.3%）表现为向心性或离心性完全填充的强化模式。此外，12例（100%）至少有一个病灶内或其附近可见明显血管。
PHA在MRI上表现多样。典型的MRI征象包括多灶性瘤内出血、病灶内或其附近的明显血管，以及PHA主要肿块不同程度的渐进性强化且填充不完全。
