Noninvasive diagnosis of small cavernous hemangioma of the liver: advantage of MRI

Abstract

Thirty

Differentiation between small hepatic hemangiomas and metastases on MR images: importance of size-specific quantitative criteria.

“…Studies have indicated that differentiation between hepatic cavernous hemangioma and liver cancer with MR imaging may be done by calculating lesion/liver signal-intensity ratio (SIR) [2,3], or lesion-to-liver contrastto-noise ratio (CNR) [4], or lesion T2 relaxation times [5,6], or by subjectively comparing signal intensities of lesion and CSF [2,4,5,7]. In emphasizing the usefulness of hepatic MR imaging for distinguishing hemangiomas from metastases, most studies have included lesions that were more than several centimeters in size.…”

Signal Intensity Characteristics of Liver Masses at Hepatobiliary Phase Images of Gadoxetate-Enhanced MR (EOB-MR): Qualitative Assessment

“…Clinicoradiological criteria of the liver masses were as follows: hypovascular hepatocellular nodules (group1) were defined as those nodules which were detected on ultrasonography (US) in patients with hepatitis or cirrhosis, and showed no hypervascularity on dynamic MDCT which were obtained within four weeks from EOB-MR, or on dynamic phase of EOB-MR. Hypervascular hepatocellular carcinoma (HCC) (group 2) were defined as lesions which exhibited typical early enhancement and subsequent washout (lower density than the surrounding hepatic tissue on portal venous or equilibrium phase images) [8] on MDCT in patients with hepatitis or cirrhosis, or those which accumulated lipiodol after transcatheter treatment in patients who had previously had pathologically proven HCC. Hemangiomas (groups 3) were defined as those for which conventional MR or dynamic CT had shown typical findings [8,9], and remained unchanged over one year. Metastases (group 4) were defined as those nodules which progressed on the follow-up imaging studies including CT/US in patients with pathologically proven primary malignancies.…”

Ressonância magnética dos hemangiomas hepáticos: avaliação das características morfológicas e quantitativas

“…Alguns autores acreditam que os valores de corte dos parâmetros quantitativos utilizados para caracterizar hemangiomas menores que 2,0 cm devem ser diferentes daqueles utilizados para caracterizar lesões maiores, com a finalidade de aumentar a sensibilidade no diagnóstico de pequenas lesões (23) . Muitos trabalhos que estudaram a caracterização quantitativa de hemangiomas e lesões hepáticas malignas excluíram da análise lesões menores que 1,0 cm (6,7,10) e até lesões menores que 2,0 cm (20) , justificando que medidas quantitativas em pequenas lesões podem ser imprecisas e degradar a utilidade dos parâmetros quantitativos na caracterização lesional. No entanto, a maioria dos hemangiomas encontrados nas séries de autópsias apresenta dimensões menores que 3,0 cm (3,25) , e assim a caracterização deste grupo de lesões merece especial atenção.…”

“…ma hepático, com acurácia variando de 85% a 97% na sua diferenciação de lesões hepáticas malignas (4)(5)(6)(7)(8)(9)(10)(11) . A caracterização do hemangioma hepático pode ser feita por meio da análise dos seus parâmetros morfológicos (7,12) , das características de impregnação pelos meios de contraste à base de gadolínio (13)(14)(15) , e também pelo estudo de parâmetros quantitativos, dos quais se destacam a relação entre a intensidade de sinal da lesão e a do parênquima hepático…”