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Published on: September 13, 2016
Retroperitoneal low-flow vascular malformations: characteristic MRI findings correlated with histopathological
Hirotaka Akita1, Yoshitake Yamada, Yoshiaki Ito
1Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Purpose:
To evaluate the MRI findings of retroperitoneal low-flow vascular malformations (RLVMs) correlated with histopathological findings.
Methods:
Two radiologists reviewed the MRI findings of 4 RLVMs (3 with capillary malformations and 1 with a venous malformation). First, they evaluated the visibility, signal intensities, and signal homogeneity of each lesion on non-fat-suppressed breath-hold T2-weighted single-shot fast spin-echo (non-FS SSFSE) images and fat-suppressed T2-weighted fast spin-echo (FS T2-weighted FSE) images. Second, the kinetic patterns and the internal enhancement patterns were analyzed for each lesion on multi-phasic contrast-enhanced (CE) images. After these image analyses, the MRI findings were correlated with the histopathological findings.
Result:
Histopathologically, the 4 RLVMs did not exhibit remarkable degeneration and were present in the retroperitoneal fat tissue without clear capsules. On the non-FS SSFSE images, 3 of the 4 RLVMs could not be discriminated from the surrounding retroperitoneal fat tissue (invisible), and the remaining lesion was barely visible with an indistinct margin. On the FS T2-weighted FSE images, however, all the RLVMs were clearly visualized as homogeneous high-signal intensities. On the multi-phasic CE images, all the capillary malformations exhibited fast enhancement, while a venous malformation showed slow enhancement. Furthermore, the RLVMs tended to exhibit a centripetal filling pattern.
Conclusion:
The RLVMs blended in with the surrounding retroperitoneal fat tissue on non-FS SSFSE images, like phantoms, whereas they were clearly visualized on FS T2-weighted FSE images. On multi-phasic CE images, the RLVMs tended to exhibit a centripetal filling pattern. These imaging features may be useful diagnostic clues for RLVMs.
