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MR imaging of hepatic hemangiomas of infancy and changes seen with interferon alpha-2a treatment
T Chung1, F A Hoffer, P E Burrows
1Department of Radiology, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
Abstract:
The purpose of this study was to describe the appearance on magnetic resonance (MR) imaging of hepatic hemangioma, and how the appearance changes in infants who have received interferon alpha-2a (IFN) treatment. We retrospectively studied 16 MR examinations in seven infants (mean age 3.2 months; range 5 days to 13 months) who were symptomatic with hepatic hemangiomas. Five of these seven patients had MR examinations both before and after treatment with IFN. In six of the seven patients, the hepatic hemangiomas were multicentric; they were usually discrete, well-defined nodules, best seen on T2-weighted images as high intensity lesions. One patient had a large solitary heterogeneous lesion. They all exhibited fast flow (seen as flow voids on spin-echo images and high signal intensity structures on gradient-recalled echo images) and enlarged hepatic arteries and veins. There was enlargement of the proximal abdominal aorta with distal tapering. Treatment was followed by accelerated regression of the hemangiomas in size and number and variable shrinkage of the enlarged vessels. As the tumor nodules regressed, they were replaced by normal-appearing hepatic parenchyma; neither fat nor fibrosis was detected by MR imaging.
Insights
Interferon alpha-2a (IFN) treatment accelerates the regression of infantile hepatic hemangiomas, improving their appearance on magnetic resonance (MR) imaging. Post-treatment MR scans show reduced tumor size and number, with vessels returning to normal.
Area of Science:
- Pediatric Radiology
- Interventional Radiology
- Hepatology
Background:
- Infantile hepatic hemangiomas are benign vascular tumors.
- Symptomatic hemangiomas may require treatment.
- Magnetic resonance (MR) imaging is crucial for diagnosis and monitoring.
Purpose of the Study:
- To describe the MR imaging appearance of infantile hepatic hemangiomas.
- To evaluate the changes in hemangioma appearance after interferon alpha-2a (IFN) treatment.
Main Methods:
- Retrospective review of 16 MR examinations in seven infants with symptomatic hepatic hemangiomas.
- MR imaging performed before and after IFN treatment in five patients.
- Analysis of lesion characteristics, vascularity, and vessel size.
Main Results:
- Hepatic hemangiomas appeared as discrete, well-defined, high-intensity nodules on T2-weighted MR images.
- Fast flow and enlarged hepatic arteries/veins were consistently observed.
- IFN treatment led to accelerated regression in size and number of hemangiomas.
- Enlarged vessels showed variable shrinkage post-treatment.
- Regressed lesions were replaced by normal hepatic parenchyma without evidence of fat or fibrosis.
Conclusions:
- MR imaging effectively characterizes infantile hepatic hemangiomas.
- Interferon alpha-2a (IFN) treatment promotes rapid regression of hepatic hemangiomas.
- IFN therapy normalizes vascular changes associated with hepatic hemangiomas.