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Perilesional enhancement of liver cavernous hemangiomas in magnetic resonance imaging
Marta S C Sousa1, Miguel Ramalho, Vasco Herédia
1Department of Radiology, Hospital Garcia de Orta, 2801-951, Almada, Portugal.
Objective:
To evaluate on magnetic resonance imaging (MRI) the occurrence rate of temporal perilesional parenchymal enhancement (PPE) associated with hepatic hemangiomas in a large consecutive series and to determine which aspects are associated with this observation.
Materials And Methods:
Institutional review board approved this retrospective study. A computerized search of the MRI database was performed for consecutive patients between January 2008 and January 2012. The study population included 513 liver hemangiomas in 224 patients (104 males and 120 females; mean age of 55.2 ± 13.5 years; age range 24-89 years). Two readers independently reviewed the frequency of PPE, size, speed of enhancement and location of each hemangioma. Marginal models with generalized estimating equation were used. Wald test was applied to verify if the model coefficients were significant.
Results:
80/513 (15.6%) hemangiomas showed PPE. The incidence of PPE was significantly higher (p < 0.05) in hemangiomas with Type1 speed of enhancement (51/80, 63.8%) than in those with Type2 or Type3. 66/80 (82.5%) hemangiomas with PPE were subcapsular (p < 0.05). Conversely, the majority (280/433, 64.7%) of hemangiomas without PPE were deep in location (p < 0.001). Lesser proportion of hemangiomas with PPE was located in segment IVa (p < 0.05).
Conclusion:
PPE is not uncommonly seen along with hepatic hemangiomas. This appearance is most frequently observed in rapidly enhancing small lesions with a subcapsular location.
Insights
Temporal perilesional parenchymal enhancement (PPE) is often seen with hepatic hemangiomas. This MRI finding is most common in small, rapidly enhancing hemangiomas located beneath the liver capsule.
Area of Science:
- Radiology
- Hepatology
- Oncology
Background:
- Hepatic hemangiomas are common benign liver tumors.
- Perilesional parenchymal enhancement (PPE) on MRI can sometimes be associated with hepatic hemangiomas, but its incidence and characteristics are not well-defined.
Purpose of the Study:
- To determine the occurrence rate of temporal perilesional parenchymal enhancement (PPE) in hepatic hemangiomas using magnetic resonance imaging (MRI).
- To identify factors associated with the presence of PPE in hepatic hemangiomas.
Main Methods:
- Retrospective analysis of 513 hepatic hemangiomas in 224 patients from an MRI database (2008-2012).
- Two radiologists independently assessed PPE, hemangioma size, enhancement speed, and location.
- Statistical analysis using marginal models with generalized estimating equations.
Main Results:
- 15.6% (80/513) of hemangiomas exhibited PPE.
- PPE was significantly more frequent in hemangiomas with Type 1 enhancement speed (63.8%) and subcapsular locations (82.5%).
- Hemangiomas without PPE were predominantly located deeper within the liver (64.7%).
Conclusions:
- Temporal perilesional parenchymal enhancement (PPE) is a relatively common finding associated with hepatic hemangiomas.
- Rapid enhancement and subcapsular location are key features associated with PPE in hepatic hemangiomas.
