Stepwise carcinogenesis of hepatocellular carcinoma in the cirrhotic liver: demonstration on serial MR imaging

PURPOSE: To demonstrate imaging findings of stepwise carcinogenesis of hepatocellular carcinoma (HCC) in cirrhosis at serial state-of-the-art MR imaging exams. MATERIALS AND METHODS: In a retrospective search of the hospital archives, three patients were identified in which developing HCC was observed in serial MR examinations, with histopathology or alpha-fetoprotein (AFP) correlation. Image findings were assessed for signal intensity of the lesions at multiple sequences, including dynamic gadolinium-enhanced imaging. RESULTS: Initial findings in patient A showed a small nodule with fatty infiltration that developed in HCC in follow-up MRI, comprised of low-grade dysplastic nodule (DN; DN I), high-grade DN (DN II), and eventually classic HCC. In patient B, increased signal intensity on T2-weighted images in a single DN among numerous regenerative nodules was the only initial sign. Follow up MRI showed further increase in signal intensity and increased neovascularity, which suggested focal HCC in a DN II. Patient C demonstrated gradually increasing neovascularity as only initial sign, with development of classic HCC over time. CONCLUSION: MR imaging provides insight in various pathways of stepwise carcinogenesis of developing HCC in cirrhosis. This may further explain the genetic heterogeneity, and may facilitate early detection and better selection of patients for follow-up.     

Small scirrhous hepatocellular carcinoma with central scar: MR imaging findings

We describe the magnetic resonance (MR) imaging findings of a small scirrhous hepatocellular carcinoma in a 74-year-old man. The initial MR imaging findings indicated that the tumor had a small central scar, which suggested the differential diagnoses of hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and metastasis. A small scirrhous hepatocellular carcinoma may have a central scar and should be included in the differential diagnoses for small hepatic masses with a central scar.     

Histological characteristics of small hepatocellular carcinomas showing atypical enhancement patterns on gadoxetic acid‐enhanced MR imaging

Purpose:

To define the histological characteristics of hepatocellular carcinomas (HCCs) showing atypical dynamic enhancement patterns on gadoxetic acid‐enhanced dynamic magnetic resonance imaging (EOB‐MRI).

Materials and Methods:

We evaluated a total of 130 small (≤3 cm) HCCs from 114 patients that were surgically removed after EOB‐MRI. Two radiologists blinded to the histological findings retrospectively classified the HCCs into typical or atypical lesions. Gross morphology, nuclear histological grade, presence of vascular invasion, and capsule formation and infiltration were compared between the two groups using Chi‐square or Fisher tests.

Results:

Atypical dynamic enhancement patterns were seen in 23 HCCs (17.7%). None of the atypical HCC showed vascular invasion (P < 0.001). Atypical HCCs also showed more frequently smaller size (1.6 ± 0.6 cm versus 2.1 ± 0.6 cm, P = 0.001) with 86.9% (n = 20) of which 2 cm or less in diameter (P = 0.001), vaguely nodular appearance (56.5% vs 3.7%, P < 0.001), and nuclear grade I (69.6% versus 6.5%, P < 0.001), while less frequently showed capsule formation (26.1% versus 77.6%, P < 0.001) or capsular infiltration (16.7% versus 77.1%, P = 0.005).

Conclusion:

Atypical HCCs on EOB‐MRI may be characterized by the absence of vascular invasion, smaller (< 2 cm or less) size, vaguely nodular appearance, and well differentiation, and infrequent capsule formation or capsular infiltration. J. Magn. Reson. Imaging 2013;37:1384–1391. © 2013 Wiley Periodicals, Inc.     

Detection of hepatocellular carcinoma by ferumoxides-enhanced MR imaging in cirrhosis: Incremental value of dynamic gadolinium-enhancement

PURPOSE: To investigate the incremental value of dynamic gadolinium-enhancement performed immediately after ferumoxides-enhanced magnetic resonance (MR) imaging on the detection of hepatocellular carcinoma in patients with cirrhosis. MATERIALS AND METHODS: We retrospectively reviewed MR scans of 62 cirrhotic patients over a two-year period. Sequences included ferumoxides-enhanced T2-weighted fast spin echo followed by dynamic gadolinium-enhanced T1-weighted spoiled gradient echo. Two readers independently documented the presence of hepatocellular carcinoma on a three-point confidence scale, without and with gadolinium-enhanced images. The presence or absence of hepatocellular carcinoma was established by histopathology (58 patients) or follow-up imaging (four patients) over a mean period of nine months. RESULTS: A total of 71 hepatocellular carcinomas were found in 42 patients. There was no statistically significant difference in sensitivity for the diagnosis of hepatocellular carcinoma without vs. with gadolinium-enhanced images (68% vs. 74% for reader 1 and 62% vs. 73% for reader 2, respectively, P > 1.3). However, both readers showed a lower mean confidence for tumor detection without vs. with gadolinium-enhanced images (2.3 vs. 2.7 for reader 1, 2.3 vs. 2.9 for reader 2, P < 0.01). CONCLUSION: In our study, the addition of dynamic gadolinium-enhancement to ferumoxides-enhanced MR imaging did not improve hepatocellular carcinoma detection, but the addition of gadolinium-enhancement is recommended if ferumoxides-enhanced imaging is used because it increased reader confidence.     

Detection of hypervascular malignant foci in borderline lesions of hepatocellular carcinoma: comparison of dynamic multi-detector row CT, dynamic MR imaging and superparamagnetic iron oxide-enhanced MR imaging

The study object was to retrospectively compare the detection rate of hypervascular foci visualized by CT during hepatic arteriography (CTHA) in borderline nodules, which was observed upon cirrhotic livers, on dynamic MDCT, dynamic gadolinium-enhanced MR (dynamic MR), and SPIO-enhanced MR imaging. Eighty-five nodules in 49 patients with cirrhosis were evaluated. When a part of the nodule showed hyperdensity relative to the surrounding areas of the nodule on CTHA, it was defined as "hypervascular focus." The relationships between the dynamic MDCT and dynamic MR and SPIO-enhanced MR imaging findings of these foci were analyzed using X(2) test. Hypervascular foci were detected in 17 (53%) of 32 on the arterial dominant phase of dynamic MDCT, in 19 (37%) of 51 on the arterial dominant phase of dynamic MR and in 6 (26%) of 23 on SPIO-enhanced MR imaging. Arterial dominant phase of dynamic MDCT demonstrated a significantly higher detection rate of hypervascular foci less than 5 mm in diameter than did dynamic and SPIO MR imaging (p<0.05). Hypervascular foci in borderline nodules could be better visualized by dynamic MDCT than by gadolinium- and SPIO-enhanced MR imaging. Dynamic MDCT is recommended for the follow-up examination of hypovascular borderline lesions.     

Using a 2D multibreath-hold susceptibility-weighted imaging to visualize intratumoral hemorrhage of hepatocellular carcinoma at 3T MRI: Correlation with pathology

Purpose:

To assess the value of 2D multibreath‐hold susceptibility‐weighted imaging (SWI) for visualizing intratumoral hemorrhage of hepatocellular carcinoma (HCC) and correlate with pathological results.

Materials and Methods:

Fifty‐eight patients with 65 HCCs underwent T1‐, T2‐, T2*‐weighted imaging and SWI. The ability to detect intratumoral hemorrhage for each imaging technique was evaluated. A radiologic‐pathological correlation was performed.

Results:

The area under the receiver operator characteristic (ROC) curve (Az value) for SWI (Az = 0.941) was significantly greater than that for T1WI (Az = 0.748) and T2WI (Az = 0.700) (P = 0.000). When compared with T2*, SWI had slightly higher sensitivity and equal specificity, but the Az value was not significantly different (P = 0.768). The total number of hemorrhages detected by SWI was greatest by factors of 13.3, 6.7, and 2.2 compared to T1WI, T2WI, and T2*, respectively. SWI detected more microbleeds (585 in 25 HCCs) than T1WI (13 in 5 HCCs), T2WI (66 in 11 HCCs), and T2* (238 in 21 HCCs).

Conclusion:

SWI can accurately visualize internal hemorrhages and provide valuable information regarding the internal architecture of HCC. J. Magn. Reson. Imaging 2012;36:900–906. © 2012 Wiley Periodicals, Inc.     

Focal liver lesions: comparison of dual-phase CT and multisequence multiplanar MR imaging including dynamic gadolinium enhancement

The purpose of this study was to compare dual-phase spiral computed tomography (CT) and magnetic resonance imaging (MRI) using dynamic gadolinium enhancement for liver lesion detection and characterization. Twenty-two consecutive patients underwent dual-phase spiral CT and MRI for the evaluation of focal liver disease within a 1-month period. Spiral CT and MR images were interpreted prospectively, in a blinded fashion by separate, individual, experienced investigators, to determine lesion detection and characterization. Liver lesions were confirmed by surgery and pathology in 6 patients, and by clinical and imaging follow-up in the other 16 patients. Pathological correlation of a primary extrahepatic malignancy was available in 5 of the 16 patients who had metastatic liver disease. Spiral CT and MRI detected 53 and 63 lesions, and characterized 39 and 62 true positive lesions, respectively. A kappa statistic test was applied to assess agreement between MR and CT results. MR versus CT for lesion detection resulted in a kappa statistic of 0.54 (95% confidence interval), indicating moderate agreement, and 0.32 (95% confidence interval) for lesion characterization, indicating only slight agreement. More lesions were detected on MR images than CT images in 6 (27%) patients, with lesions detected only on MR images in 4 (18%) patients. More lesions were characterized on MR images in 9 (41%) patients. In 9 patients with a discrepancy between MR and CT findings, the MR images added information considered significant to patient management in all 9 cases. MRI was moderately superior to dual-phase spiral CT for lesion detection, and was markedly superior for lesion characterization, with these differences having clinical significance.     

Hepatocellular carcinoma of diffuse type: MR imaging findings and clinical manifestations

PURPOSE: To assess MR imaging findings and clinical manifestations of diffuse-type hepatocellular carcinoma (HCC). MATERIALS AND METHODS: We retrospectively reviewed our experience with diffuse HCC from November 1994 to October 2001. MR imaging findings and clinical features were assessed. RESULTS: Twenty-two consecutive patients with diffuse-type HCC (19 men and three women, age range 16-80 years [mean, 52 years]) were identified in a review of liver MR studies. This represented 13% of all patients with HCC imaged during this time period. Diffuse HCC showed a permeative, infiltrative pattern with ill-defined borders and no evidence of convex margination in all cases. At least 50% of the liver volume was involved with tumor. Diffuse-type HCC showed hypointensity in 15 patients, mixed intensity in three, and isointensity in four on T1-weighted images; heterogeneous hyperintensity in 16 patients; and homogeneous hyperintensity in six on T2-weighted MR images. Diffuse-type HCC showed patchy enhancement in 12 patients, miliary enhancement in nine, and minimal enhancement in one on postcontrast early-phase images, and showed heterogeneous wash-out in all patients on postcontrast late-phase images. Proximal portal venous tumor thrombosis was seen in all patients. Serum alpha-fetoprotein (AFP) value was elevated (>10 ng/mL) in 14 of 18 patients, and 13 showed a value greater than 500 ng/mL. The four patients who did not have elevated AFP had tumors which were indistinguishable from those in patients with elevated AFP; they also did not have a distinctive clinical history. CONCLUSION: Diffuse-type HCC was typically seen as an extensive, heterogeneous permeative hepatic tumor, with portal venous tumor thrombosis on MR images in all cases. Early enhancement, observed as patchy in 12 and miliary in nine of 22 patients, was a distinctive imaging feature. Elevated serum AFP value was a common finding; however, 22% had normal values.     

van der Knaap syndrome: MR imaging findings including FLAIR, diffusion imaging, and proton MR spectroscopy

A patient is reported with diffuse leukoencephalopathy associated with cystic degeneration of the white matter of the brain (van der Knaap syndrome). The changes were studied by fluid attenuated inversion recovery (FLAIR), and diffusion-weighted MR imaging. The FLAIR sequence revealed suppressed signal of the cysts, and widespread high-signal white matter changes associated with thinned cortices. On diffusion-weighted MR imaging, apparent diffusion coefficient (ADC) values ranged from 3.0 × 10^–3 to 2.7 × 10^–3 mm²/s in the temporal cysts, similar to that of CSF. The ADC values within the parenchyma ranged between 2 × 10^–3 and 2.1 × 10^–3 mm²/s, a value falling between normal parenchyma and cerebrospinal fluid, compared with a control group of three healthy subjects. The changes were also evaluated by proton MR spectroscopy, and were compared with a control group of 12 cases. Magnetic resonance spectroscopy revealed apparently increased NAA/Cr ratios in most parts of the brain. The NAA/Cho ratios were either high or low, and the Cho/Cr ratios were increased or normal in different regions. Received: 27 October 1999; Revised: 9 December 1999; Accepted: 20 December 1999     

Value of delayed hypointensity and delayed enhancing rim in magnetic resonance imaging diagnosis of small hepatocellular carcinoma in the cirrhotic liver

Purpose:

To determine the diagnostic utility of delayed hypointensity and delayed enhancing rim on magnetic resonance imaging (MRI) as indicators of hepatocellular carcinoma (HCC) in arterially enhancing nodules ≤5 cm in the cirrhotic liver and determine the features that best predict HCC.

Materials and Methods:

Gadolinium‐enhanced MRI studies performed from January 2001 to December 2004 in patients with cirrhosis were evaluated for arterially enhancing nodules measuring ≤5 cm. Verification was via explant correlation, biopsy, or imaging follow‐up. Sensitivity and specificity of diagnostic features of HCC were calculated. Features predictive of HCC were determined using the Generalized Estimating Equation approach.

Results:

In all, 116 arterially enhancing nodules were identified in 80 patients (<2 cm: n = 79, 2–5 cm n = 37). Sensitivity and specificity of delayed hypointensity for HCC measuring ≤5 cm, 2–5 cm, and <2 cm were 0.54 (40 of 74) and 0.86 (36 of 42); 0.72 (23 of 32) and 0.80 (4 of 5); and 0.41 (17 of 42) and 0.87 (32 of 37). For the delayed enhancing rim sensitivity and specificity were 0.64 (47 of 74) and 0.86 (36 of 42); 0.75 (24 of 32) and 1.0 (5 of 5); and 0.55 (23 of 42) and 0.83 (31 of 37), respectively. Lesion size (≥2 cm) and delayed enhancing rim, as main features and their interaction, were the most significant predictors of HCC.

Conclusion:

Delayed hypointensity and enhancing rim improve the specificity of diagnosis of HCC of all sizes but are seen less frequently in small (<2 cm) HCC. Nodule size (≥2 cm) and delayed enhancing rim are the strongest predictors of HCC. J. Magn. Reson. Imaging 2010;32:360–366. © 2010 Wiley‐Liss, Inc.     

MR imaging findings of uterine endometrial stromal sarcoma: differentiation from endometrial carcinoma

Endometrial stromal sarcoma (ESS) is a rare malignant neoplasm of the uterus. We retrospectively analyzed pelvic MR imaging in 8 cases of ESS to determine the characteristic MR findings of ESS. Magnetic resonance images of 8 cases of ESS were evaluated for findings including the size, margin of the tumor, nodular lesions at the tumor margin, intramyometrial worm-like nodular extension, multiple nodular mass formation, hemorrhage, and necrosis in the tumor. The degree of contrast enhancement was also analyzed. The MR imaging findings of 21 consecutive cases of endometrial carcinoma (EC) were also evaluated and compared with those of ESS. The mean and the standard deviation of the maximum diameter of ESS and EC were 8.80 ± 4.99 and 3.93 ± 2.47 cm, respectively. Increased enhancement in at least a part of the tumor was observed in five of the six analyzed ESS cases and in 2 of 12 analyzed EC cases. The irregular margin, nodular lesions at the margin, intramyometrial nodular extension, and multiple nodular mass formation were more frequently seen in cases of ESS than in cases of EC. Magnetic resonance imaging can play a role in both diagnosing ESS as well as in differentiating ESS from EC. Received: 17 December 1999 Revised: 18 May 2000 Accepted: 22 May 2000     

The pseudocapsule in hepatocellular carcinoma: correlation between dynamic MR imaging and pathology

Nodular hepatocellular carcinoma (HCC) is characterized by the presence of a pseudocapsule (constructed usually from connective fibrous tissue) that appears hypointense on T1- and T2-weighted spin-echo (SE) and gradient-echo (GE) MR imaging sequences without a contrast medium. The presence of vascular structures inside the tumor, which are verified by histological exam, affects enhancement of the PC after administrating the contrast medium: The impregnation is more evident in the dynamic study but also persists on the delayed T1-weighted SE images. The accuracy of MR in detecting the pseudocapsule of HCC and contrast enhancement of the pseudocapsule during dynamic studies were evaluated and related to pathological findings. Thirty-seven HCC were examined in 33 patients and afterwards resected. In capsulated nodules, besides usual hematoxylin, eosin, and trichrome stainings, histochemical and immunohistochemical methods were performed. On a 1.5-T MR unit, T1- and T2-weighted SE and GE FLASH 2D sequences after intravenous injection of Gd-DTPA (dynamic study) were used. In a later phase, T1-weighted SE sequences were repeated. Histologically, the pseudocapsule (thickness 0.2–6 mm) was present in 26 of 37 nodules (70 %). The dynamic study was the most suitable technique to show the pseudocapsule, which was recognized in 80.7 % (21 of 26 nodules). In 5 of 26 cases, the pseudocapsule, not demonstrated by MR, was thinner than 0.4 mm. In 16 of 21 cases, in the early portal phase (30–60 s), the pseudocapsule had an early enhancement, which was more evident later; in 5 of 21 cases the enhancement was observed only in the late portal phase (1–2 min). At histological examination, 14 of 16 pseudocapsules with early enhancement showed a more prominent vasculature than those with enhancement in the equilibrium phase. Magnetic resonance was a reliable tool in demonstrating the pseudocapsule of HCC. The histological examination demonstrated a good correlation between the enhancement behavior and the vessel number of the pseudocapsule. Received: 28 July 1997; Revision received: 9 February 1998; Accepted: 20 March 1998     

肝细胞癌MR信号强度与组织学和DNA含量的关系

用０．３５Ｔ磁共振仪检查４１例肝细胞癌（ＨＣＣ），均经手术、病理证实，将磁共振信号强度按Ｔ１／Ｔ２分为稍低／稍高信号、低／高信号及信号不均３组；组织学上分为梁索优势型、假腺管优势型及实质优势型；用图像分析仪测量每例癌细胞核ＤＮＡ含量，计算ＤＮＡ指数（ＤＩ）及倍型。分析肝细胞癌ＭＲ信号与组织学和ＤＮＡ含量的相关性。结果显示，稍低／稍高信号组，以梁索优势型为多，占８２．６％，平均ＤＩ为２．３９；低／高信号组，以实质优势型为多，占７１．４％，平均ＤＩ为３．７８，二者差异显著，结果表明，ＨＣＣ的ＭＲ信号改变在一定程度上反映了不同的组织学类型和ＤＮＡ含量的高低。     

Additional value of gadoxetic acid-DTPA-enhanced hepatobiliary phase MR imaging in the diagnosis of early-stage hepatocellular carcinoma: comparison with dynamic triple-phase multidetector CT imaging

Purpose:

To assess the value of hepatobiliary phase gadoxetic acid (EOB)‐enhanced magnetic resonance imaging (MRI) for the diagnosis of early stage hepatocellular carcinoma (HCC) (<3 cm) compared to triple‐phase dynamic multidetector computed tomography (MDCT).

Materials and Methods:

In all, 52 patients with 60 pathologically proven HCCs underwent both EOB‐enhanced MRI and triple‐phase dynamic MDCT. Two radiologists independently and blindly reviewed three image sets: 1) MDCT, 2) dynamic MRI (unenhanced and EOB‐enhanced dynamic MR images), and 3) combined MRI (dynamic MRI + hepatobiliary phase images) using a five‐point rating scale on a lesion‐by‐lesion basis. Receiver operating characteristics (ROC) analysis was performed, and sensitivity and specificity were calculated.

Results:

The area under the ROC curve (Az) of dynamic MRI was equivalent to that of MDCT for both readers. For both readers, Az and sensitivity of combined MRI for smaller lesions (<1.5 cm) were significantly higher than that of dynamic MRI and MDCT (P < 0.0166). The majority of false‐negative nodules on dynamic MRI or MDCT (75% and 62%, respectively) were due to a lack of identified washout findings.

Conclusion:

Hepatobiliary phase images can increase the value of EOB‐enhanced MRI in the diagnosis of early stage HCC. The sensitivity and accuracy were significantly superior to MDCT for the diagnosis of lesions less than 1.5 cm. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.     

Ferumoxide-enhanced MR imaging of hepatocellular carcinoma: correlation with histologic tumor grade and tumor vascularity

PURPOSE: To evaluate ferumoxide-enhanced MR imaging findings of hepatocellular carcinomas (HCCs) in correlation with the histologic tumor grades and the tumor vascularity evaluated by CT hepatic arteriography (CTHA) and CT during arterial portography (CTAP) combined. MATERIALS AND METHODS: By searching the radiologic, surgical, and pathologic reports of our institution between January 1999 and February 2001, we identified 43 patients with 51 pathologically confirmed HCCs who underwent ferumoxide-enhanced MR imaging and combination CTHA and CTAP within two weeks. The HCCs consisted of 17 well-differentiated, 28 moderately differentiated, and six poorly differentiated tumors. The MR and CT were retrospectively reviewed by two radiologists in consensus for signal intensity on MR images and vascularity on CT. The Spearman's rank correlation coefficient was calculated to correlate the frequency of tumors with ferumoxide uptake with the histologic tumor grades and the tumor vascularity on CTHA and CTAP. RESULTS: A total of 45 tumors (88%) did not take up ferumoxide, and thus showed distinct, homogeneous hyperintensity. Six tumors (12%) ranging 5-16 mm in size (mean, 11 mm) took up ferumoxide, and thus showed isointensity, mixed intensity, or hypointensity, including five of 17 (29%) well-differentiated tumors and one of 28 (4%) moderately differentiated tumors. Five of the six tumors (83%) showed hyper- or hypovascularity on CTHA or hypovascularity on CTAP. The frequency of tumors with ferumoxide uptake showed weak correlation with tumor grades (coefficient = 0.26, P < 0.01) and vascularity on CTHA (-0.35, P < 0.05) and CTAP (0.39, P < 0.01). CONCLUSION: Although a small number of well-differentiated HCC take up ferumoxide and show iso-, mixed, or hypointensity, most such tumors show increased hepatic arterial or decreased portal venous perfusion. The present results suggest the limitation of reticuloendothelial contrast imaging, particularly in the diagnosis of small, well-differentiated HCC.     

Gadobenate dimeglumine-enhanced liver MR imaging in cirrhotic patients: quantitative and qualitative comparison of 1-hour and 3-hour delayed images

Purpose:

To compare the image quality and diagnostic performance of 1‐ and 3‐h delayed‐phase MR images (DPIs) after gadobenate dimeglumine injection in detecting small hepatocellular carcinomas (HCCs) in cirrhotic patients.

Materials and Methods:

Relative enhancement of the liver (RE_liver) and HCC (RE_HCC) and liver‐to‐lesion contrast‐to‐noise ratio (CNR) of HCC were measured quantitatively on 1‐ and 3‐h DPIs in 65 patients with 88 HCCs. For qualitative analysis, two radiologists independently evaluated three image sets in 19 patients with 25 HCCs ≤2 cm and in 16 controls without HCCs: conventional liver MR without DPI (set A), adding 1‐h DPI (set B), and adding 3‐h DPI (set C), using a 5‐point scale for diagnosing small HCCs. Diagnostic performance for small HCCs was analyzed using the alternative free‐response receiver operating characteristic method.

Results:

Mean RE_liver (P = 0.013) and RE_HCC (P < 0.001) were significantly higher on 1‐h than on 3‐h DPI, whereas CNR was significantly higher on 3‐h than on 1‐h DPI (P = 0.001). Observer‐averaged figure of merit (FOM) was significantly higher for set C than for set A (0.942 versus 0.883; P = 0.013).

Conclusion:

In cirrhotic patients, 3‐h DPI provides a higher liver‐to‐lesion contrast and a better diagnostic performance for small HCCs than 1‐h DPI. J. Magn. Reson. Imaging 2011;33:889–897. © 2011 Wiley‐Liss, Inc.     

脉络膜血管瘤的MRI表现及动态增强研究

Objective To characterize the regular and the dynamic contrast enhancement MR imaging in choroidal hemangioma.Methods MR imaging findings of 30 cases (31eyes, 32 lesions) with choroidal hemangioma confirmed by follow-up results were retrospectively analyzed.Among them, postcontrasted T1-weighted imaging was performed in 30 patients and dynamic contrast enhancement scanning was performed in 26 cases.MRI findings and the time-intensity curve of dynamic contrast enhancement were analyzed.Results Among the 32 choroidal hemangiomas, 26 of them were at the temporal side of optic disc and 28 lesions were fusiform.Before enhancement, 23 lesions showed isointense T1-weighted signal and 31 lesions were isointense on T2-weighted imaging.All the lesions showed strong enhancement on postcontrast T1-weighted imaging, including 31 homogenously enhanced lesions and one heterogeneously enhanced lesion.Retinal detachments were found in 18 eyes.Fill-in sign were observed in 12 lesions during dynamic contrast enhancement.The time-intensity curve of dynamic contrast enhancement in 28 lesions suggested a pattern with rapid enhancement and slow washout, time to peak (91.00±25.27) s, slope ratio 3.03±1.13, the median of washout ratio 17.06%, enhancement ratio 2.87±0.79.Conclusion MRI showed a few features of the location, shape, signal characteristics, and enhancement pattern in choroidal hemangioma, which may contribut to diagnosis and treatment plan of this disease.     

脉络膜血管瘤的MRI表现及动态增强研究

Objective To characterize the regular and the dynamic contrast enhancement MR imaging in choroidal hemangioma.Methods MR imaging findings of 30 cases (31eyes, 32 lesions) with choroidal hemangioma confirmed by follow-up results were retrospectively analyzed.Among them, postcontrasted T1-weighted imaging was performed in 30 patients and dynamic contrast enhancement scanning was performed in 26 cases.MRI findings and the time-intensity curve of dynamic contrast enhancement were analyzed.Results Among the 32 choroidal hemangiomas, 26 of them were at the temporal side of optic disc and 28 lesions were fusiform.Before enhancement, 23 lesions showed isointense T1-weighted signal and 31 lesions were isointense on T2-weighted imaging.All the lesions showed strong enhancement on postcontrast T1-weighted imaging, including 31 homogenously enhanced lesions and one heterogeneously enhanced lesion.Retinal detachments were found in 18 eyes.Fill-in sign were observed in 12 lesions during dynamic contrast enhancement.The time-intensity curve of dynamic contrast enhancement in 28 lesions suggested a pattern with rapid enhancement and slow washout, time to peak (91.00±25.27) s, slope ratio 3.03±1.13, the median of washout ratio 17.06%, enhancement ratio 2.87±0.79.Conclusion MRI showed a few features of the location, shape, signal characteristics, and enhancement pattern in choroidal hemangioma, which may contribut to diagnosis and treatment plan of this disease.     

脉络膜血管瘤的MRI表现及动态增强研究

Objective To characterize the regular and the dynamic contrast enhancement MR imaging in choroidal hemangioma.Methods MR imaging findings of 30 cases (31eyes, 32 lesions) with choroidal hemangioma confirmed by follow-up results were retrospectively analyzed.Among them, postcontrasted T1-weighted imaging was performed in 30 patients and dynamic contrast enhancement scanning was performed in 26 cases.MRI findings and the time-intensity curve of dynamic contrast enhancement were analyzed.Results Among the 32 choroidal hemangiomas, 26 of them were at the temporal side of optic disc and 28 lesions were fusiform.Before enhancement, 23 lesions showed isointense T1-weighted signal and 31 lesions were isointense on T2-weighted imaging.All the lesions showed strong enhancement on postcontrast T1-weighted imaging, including 31 homogenously enhanced lesions and one heterogeneously enhanced lesion.Retinal detachments were found in 18 eyes.Fill-in sign were observed in 12 lesions during dynamic contrast enhancement.The time-intensity curve of dynamic contrast enhancement in 28 lesions suggested a pattern with rapid enhancement and slow washout, time to peak (91.00±25.27) s, slope ratio 3.03±1.13, the median of washout ratio 17.06%, enhancement ratio 2.87±0.79.Conclusion MRI showed a few features of the location, shape, signal characteristics, and enhancement pattern in choroidal hemangioma, which may contribut to diagnosis and treatment plan of this disease.