Intravascular papillary endothelial hyperplasia of the digit: MRI features with histological correlation
1Department of Orthopaedic Surgery, Tamanagayama Hospital, Nippon Medical School, Tokyo, Japan. kitayasu@nms.ac.jp
Abstract:
To clarify the magnetic resonance (MR) features of the pure form of intravascular papillary endothelial hyperplasia, MR images (MRIs) from five patients were retrospectively reviewed and compared with histological findings. The images showed a heterogeneous, iso- to slightly high signal intensity mass on T1-weighted images and a mass with a central heterogeneous, iso- to slightly high signal intensity area completely or incompletely surrounded by peripheral high signal intensity areas on T2-weighted images. Heterogeneous enhancement was observed after gadolinium administration. Histological studies indicated that the central heterogeneous area on T2-weighted images corresponded to thrombi (organized and/or hyalinized) and/or papillary endothelial proliferation, and also that the peripheral high signal intensity area corresponded to vascular blood space and/or papillary endothelial proliferation. The pure form of intravascular papillary endothelial hyperplasia showed relatively characteristic features on MRIs.
Insights
Magnetic resonance imaging (MRI) reveals distinct features of intravascular papillary endothelial hyperplasia. These findings aid in diagnosing this rare vascular tumor using T1-weighted, T2-weighted, and post-contrast MRI sequences.
Area of Science:
- Radiology
- Pathology
- Vascular Medicine
Background:
- Intravascular papillary endothelial hyperplasia (IPEH) is a rare vascular lesion.
- The pure form of IPEH can present diagnostic challenges.
- Understanding its specific magnetic resonance (MR) imaging characteristics is crucial for accurate diagnosis.
Purpose of the Study:
- To elucidate the characteristic magnetic resonance (MR) imaging features of the pure form of intravascular papillary endothelial hyperplasia (IPEH).
- To correlate MR imaging findings with histological results in patients with IPEH.
Main Methods:
- Retrospective review of MR images from five patients diagnosed with pure IPEH.
- Comparison of MR imaging findings with corresponding histological examinations.
- Analysis of signal intensities on T1-weighted and T2-weighted images, and enhancement patterns post-gadolinium administration.
Main Results:
- MR imaging demonstrated a heterogeneous mass with iso- to slightly high signal intensity on T1-weighted images.
- T2-weighted images showed a central heterogeneous area (iso- to slightly high signal intensity) surrounded by peripheral high signal intensity areas.
- Heterogeneous enhancement was observed after gadolinium administration, with histological correlation identifying thrombi and/or endothelial proliferation centrally and vascular spaces/endothelial proliferation peripherally.
Conclusions:
- The pure form of intravascular papillary endothelial hyperplasia exhibits relatively characteristic features on MR imaging.
- Specific MR imaging findings, particularly on T2-weighted sequences and post-contrast enhancement, are valuable for differentiating IPEH.
- Correlation with histology confirms the interpretation of MR imaging findings, aiding in diagnosis.
