Lewin Maïté, Aldhaheri Rauda, Beaufrère Aurélie, Desterke Christophe, Paisant Anita, Bricault Ivan, Borde Paul, Simon Gabriel, Lesurtel Mickaël, Cherqui Daniel, Prud'Homme Clara, Vilgrain Valérie, Laurent-Bellue Astrid
Department of Radiology, Paul Brousse University Hospital, AP-HP-University Paris Saclay, Villejuif, France.
Department of Pathology, Beaujon Hospital, FHU MOSAIC, AP-HP University Paris-Cité, Clichy, France.
Eur Radiol. 2025 Sep 4. doi: 10.1007/s00330-025-11915-4.
The aim of this study was to describe the imaging features on dynamic CT and MRI of a series of pathologically confirmed low-grade vascular neoplasia of the liver (LGVNL).
In this retrospective multicenter study, patients diagnosed with pathologically proven LGVNL between January 2014 and August 2024 and with cross-sectional imaging (CT or MRI) were included. Based on prior studies, we divided the patients into two groups: a group with typical LGVNL features and a group with atypical tumors. Univariable analysis and the logistic regression model were used to evaluate the outcome of typical and atypical LGVNL features.
Twenty-eight patients were included (20 men, mean age 53.7 ± 13.4 [SD] years old). The median size of tumors at diagnosis was 22 mm [IQR, 10-80]. A typical LGVNL pattern including thick continuous peripheral arterial phase "flower petal shape" enhancement was found on MRI in 67% (18/27) with lobulated lesions (p = 0.001), a marked hypersignal on T2-weighted images (p = 0.003) and a high apparent diffusion coefficient (ADC) (mean tumor ADC, 2.1 × 10 ± 0.3 [SD] mm/s) (p = 0.006) with portal and delayed phase filling following contrast administration. An atypical LGVNL pattern was found in 33% (9/27), including homogeneous arterial phase enhancement that persisted during the portal and delayed phases. After a median follow-up of 16 months, tumor growth was observed in 42% (8/19) and was faster in patients with the atypical LGVNL pattern (p = 0.013).
The typical imaging pattern of LGVNL that includes arterial phase "flower petal shape" enhancement with a marked hypersignal on T2-weighted images and a high ADC was seen in most cases.
Question Low-grade vascular neoplasia of the liver, including hepatic small vessel neoplasms and anastomosing hemangioma, is a new entity of vascular tumors with few radiological descriptions. Findings Diagnostic imaging criteria include the "flower petal shape" enhancement pattern on arterial phase, a marked hypersignal on T2-weighted images and high ADC values. Clinical relevance This multicenter study provides clinical, pathological and imaging data on low-grade vascular neoplasia of the liver and highlights specific imaging features for its diagnosis. Knowledge of these imaging features helps eliminate differential diagnoses.
本研究旨在描述一系列经病理证实的肝脏低度血管性肿瘤（LGVNL）在动态CT和MRI上的影像特征。
在这项回顾性多中心研究中，纳入了2014年1月至2024年8月间经病理证实为LGVNL且有横断面成像（CT或MRI）的患者。基于先前的研究，我们将患者分为两组：具有典型LGVNL特征的一组和具有非典型肿瘤的一组。采用单因素分析和逻辑回归模型评估典型和非典型LGVNL特征的结果。
共纳入28例患者（20例男性，平均年龄53.7±13.4[标准差]岁）。诊断时肿瘤的中位大小为22mm[四分位间距，10 - 80]。在MRI上，67%（18/27）有分叶状病变的患者出现典型的LGVNL模式，包括厚的连续周边动脉期“花瓣状”强化（p = 0.001），T2加权图像上有明显高信号（p = 0.003），以及高表观扩散系数（ADC）（平均肿瘤ADC，2.1×10±0.3[标准差]mm/s）（p = 0.006），对比剂注入后门静脉期和延迟期有填充。33%（9/27）的患者出现非典型LGVNL模式，包括动脉期均匀强化且在门静脉期和延迟期持续。中位随访16个月后，42%（8/19）的患者观察到肿瘤生长，非典型LGVNL模式的患者肿瘤生长更快（p = 0.013）。
大多数情况下可见LGVNL的典型影像模式，包括动脉期“花瓣状”强化、T2加权图像上有明显高信号和高ADC值。
问题肝脏低度血管性肿瘤，包括肝小血管肿瘤和吻合性血管瘤，是一种新的血管肿瘤实体，影像学描述较少。发现诊断性影像标准包括动脉期“花瓣状”强化模式、T2加权图像上有明显高信号和高ADC值。临床意义这项多中心研究提供了关于肝脏低度血管性肿瘤的临床、病理和影像数据，并突出了其诊断的特定影像特征。了解这些影像特征有助于排除鉴别诊断。
