CT and MRI studies of hepatic angiosarcoma

• Published in: Clinical radiology 2019-05, Vol.74 (5), p.406.e1-406.e8
• Main Authors: Yi, L.-L., Zhang, J.-X., Zhou, S.-G., Wang, J., Huang, Y.-Q., Li, J., Yu, X., Wang, R.-N.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Contrast Media; Female; Hemangiosarcoma - pathology; Humans; Liver Neoplasms - pathology; Magnetic Resonance Imaging - methods; Male; Middle Aged; Tomography, X-Ray Computed - methods; Young Adult
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2018.12.013

To analyse the computed tomography (CT) and magnetic resonance imaging (MRI) manifestations of hepatic angiosarcoma. Nineteen patients with hepatic angiosarcoma underwent preoperative abdominal unenhanced and contrast-enhanced CT (11 cases) or (eight cases) MRI. The results of a coagulation examination showed varying degrees of abnormalities in 12 (63.16%) cases (most were prolonged prothrombin time and an increased proportion of prothrombin time), which were the most common abnormalities on the laboratory tests. Unenhanced CT of the lesions showed homogeneous or heterogeneous hypointense with hyperintense haemorrhagic lesions, contrast-enhanced CT was performed for six cases (6/11, 54.5%) with centripetal heterogeneous filling. All lesions showed heterogeneous intensity at MRI, including heterogeneous hypointense T1WI and homogeneous or heterogeneous hyperintense T2WI. Haemorrhage lesions showed higher hyperintensity with spot or patchy signals. Centripetal enhancement was found in six cases using contrast-enhanced imaging. Flaky patches of contrast enhancement were seen in the lesions. The CT and MRI features of most of the hepatic angiosarcomas in the present study were relatively characteristic: the border of the mass was indistinct, the density was heterogeneous, and haemorrhage was frequently seen, with secondary calcification in a few cases, whereas enhanced imaging showed typical centripetal heterogeneous enhancement. In addition, highly malignant angiosarcoma could not be enhanced. •The coagulation examination showed varying degrees of abnormalities in 12 (63.16%) cases.•The plain CT scan of the lesions showed homogeneous or heterogeneous hypointense with hyperintense hemorrhagic lesions.•Enhanced scans were typically characterized by the continuous centripetal filling during the venous and delay phases.