[Imaging findings of pediatric Kaposiform hemangioendothelioma]

To summarize the imaging findings of Kaposiform hemangioendothelioma (KHE). A retrospective review was conducted on clinical data from pediatric patients diagnosed with KHE through surgery or biopsy at the Children's Hospital of Nanjing Medical University between January 2014 and January 2023. Based on the depth of lesion involvement, KHE was categorized into superficial, deep, and mixed types. Based on the affected tissues and organs, KHE was categorized into bone KHE, soft tissue KHE, and deep organ (pancreas, intestinal wall mesentery) KHE. A total of 25 children were included, including 15 male and 10 female patients, with a median age of 5 months (ranging from 21 hours to 9 years and 7 months). Seventeen cases occurred within 1 year old, 5 cases between 1 and 5 years, and 3 cases beyond 5 years. Among the cases, there were 11 cases of deep type, 11 cases of mixed type, and 3 cases of superficial type. Soft tissue KHE was observed in 17 cases, deep organ KHE in 2 cases, and bone KHE in 6 cases. Non-contrast CT of soft tissue and deep organs KHE presented as nodular, large or diffuse slightly low density with borderless diffuse, non-contrast MRI showed equal or slightly lower T1, higher T2 signal, with significant enhancement after enhancement. The X-ray and CT of bone KHE presented as worm erosion or osteolytic bone destruction accompanied by peripheral bone hyperplasia and sclerosis, MRI plain scan showed equal or slightly lower T1, mixed or slightly higher T2 signal, with lower T2 signal inside and around the lesion, and with no enhancement after enhancement. Soft tissue and deep organs KHE presents as infiltrative growth, with enhancement after CT or MRI enhancement. In contrast, bone KHE is localized, and characterized by concurrent bone destruction and sclerosis, with no enhancement after CT or MRI enhancement.