Imaging findings of primary hepatic angiosarcoma on gadoxetate disodium-enhanced liver MRI: comparison with hepatic haemangiomas of similar size

• Published in: Clinical radiology 2018-03, Vol.73 (3), p.244-253
• Main Authors: Kim, B., Byun, J.H., Lee, J.H., Park, B.J., Kwon, H.-J., Lee, S.J., Won, H.J., Shin, Y.M., Kim, P.N.
• Format: Article
• Language: English
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2017.09.015

To describe imaging characteristics of primary hepatic angiosarcoma on gadoxetate disodium-enhanced dynamic magnetic resonance imaging (MRI) and to determine features that differentiate angiosarcomas from similar-sized haemangiomas. The study included 15 patients with hepatic angiosarcomas and 35 patients with size-matched hepatic haemangiomas who underwent gadoxetate disodium-enhanced liver MRI. The number, size, growth pattern, signal intensity (SI) characteristics, and SI changes on dynamic scans were evaluated and compared between the two entities. Overall, hepatic angiosarcomas significantly more often showed lesion multiplicity (86.7%), capsular retraction (40%), prominent intratumoural vessels (66.7%), vascular invasion (20%), heterogeneous SI on T2-weighted (100%) and hepatobiliary phase images (80%), and intralesional haemorrhage (60%, all p6 cm in diameter. Gadoxetate disodium-enhanced dynamic liver MRI is capable of depicting vascular hallmarks of hepatic angiosarcomas. Heterogeneous SI on T2-weighted and hepatobiliary phase images, multiplicity, and an enhancement curve following that of the aorta are also distinctive features that differentiate angiosarcomas from haemangiomas. •Gadoxetate disodium-enhanced MRI visualizes vascular features that can differentiate hepatic angiosarcomas from haemangiomas.•Bizarrely shaped enhancing foci, heterogeneous signal on T2-weighted and hepatobiliary phase images, multiplicity, and an enhancement curve following that of the aorta are imaging features that differentiate angiosarcomas from haemangiomas on MRI.•Hepatic angiosarcomas smaller than 3 cm lacked arterial enhancement on gadoxetate disodium-enhanced MRI.