Imaging of cholangiolocellular carcinoma of the liver

Aim

Cholangiolocellular carcinoma (CoCC) is currently considered to originate from hepatic progenitor cells. The purpose of this study was to evaluate the imaging features of cholangiolocellular carcinoma of the liver.

Materials and methods

Five cases of surgically resected cases of CoCC from 4 institutions were retrospectively evaluated. All of the five patients underwent contrast-enhanced dynamic CT. MRI and angio-CT including CT during arterioportography (CTAP) and CT during hepatic arteriography were performed in 3 and 2 patients, respectively. Histological evaluation was also performed and was correlated with radiographic findings.

Results

On dynamic CT or MRI, the lesions presented hypervascular tumors with delayed washout in 2 cases and in the other 3 cases, the lesions showed peripheral enhancement with concentric delayed filling. On CTAP, the continued existence of portal veins or tiny spots of portal flow was identified in the tumors. Fibrous capsule or tumor necrosis was not observed.

Conclusion

CoCC tumors have the dual imaging characteristics of hepatocellular carcinoma and cholangiocarcinoma. The absence of a fibrous capsule, the absence of tumor necrosis, peripheral location within the liver, and the presence of portal venous penetration within the tumor also appear to be characteristic features.     

Magnetic resonance imaging in fetal anomalies: What does it add to 3D and 4D US?

Objective

The objective of our study is to evaluate the contribution of adding MRI findings to sonographic data when assessing fetal anomalies and to determine how this addition may affect the management of pregnancy.

Study design

We prospectively examined 26 fetuses who had sonographically suspected congenital anomalies over a period of 1 year. 2D/3D and 4D ultrasound, Doppler and magnetic resonant imaging was done for all patients. MRI was done within 1 week following US examination. The maternal age range was 18-39 years. The gestational age range was 15-38 weeks (mean age = 29 weeks). Ultrasound and magnetic resonance findings were compared together.

Results

We reported different types of congenital anomalies including eight cases of isolated central nervous system anomalies, four abdominal, five musculoskeletal anomalies, seven cases of renal anomalies and two cases of Meckel Gruber syndrome. MRI and sonography showed concordant findings in 18 cases. MRI changed the diagnosis in five cases and provided additional information in three cases. Ultrasound was superior to magnetic resonance imaging in three cases.

Conclusion

Our results showed that fetal MR imaging can be used as a complementary modality to US in diagnosing fetal abnormality in which US findings are inconclusive or equivocal.     

Value of CT lymphangiography in the detection of lymphatic leakage: a report of nine cases

Purpose

To demonstrate the value of CT lymphangiography to detect lymphatic leakage, especially at the thoracic level, prior to therapeutic intervention.

Patients and methods

Between 2004 and 2008, nine patients underwent lymphangiography, followed by CT for the evaluation of intractable lymphatic leakage in spite of optimal medical management. Patients included seven females and two males, with age ranging between 25 and 58 years. Lymphangiography was performed after unilateral or bilateral foot injection(s) of Lipiodol ultrafluid followed by standard radiographs of the chest and abdomen and CT of the chest, abdomen and pelvis. The images were reviewed by two experienced radiologists.

Results

Lipiodol leakage was observed in six patients, while three patients showed evidence of lymphangiectasia of the abdominal and/or thoracic lymphatics. Spontaneous resolution of leakage after lymphangiography occurred in three cases.

Conclusion

CT lymphangiography allows direct evaluation of lymphatics, from pelvis to chest, in order to detect the site of leakage at the origin of a chylous effusion and assist in its management.     

Visualization of morphological parenchymal changes in emphysema: comparison of different MRI sequences to 3D-HRCT

Purpose

Thin-section CT is the modality of choice for morphological imaging the lung parenchyma, while proton-MRI might be used for functional assessment. However, the capability of MRI to visualize morphological parenchymal alterations in emphysema is undetermined. Thus, the aim of the study was to compare different MRI sequences with CT.

Materials and methods

22 patients suffering from emphysema underwent thin-section MSCT serving as a reference. MRI (1.5 T) was performed using three different sequences: T2-HASTE in coronal and axial orientation, T1-GRE (VIBE) in axial orientation before and after application of contrast media (ce). All datasets were evaluated by four chest radiologists in consensus for each sequence separately independent from CT. The severity of emphysema, leading type, bronchial wall thickening, fibrotic changes and nodules was analyzed visually on a lobar level.

Results

The sensitivity for correct categorization of emphysema severity was 44%, 48% and 41% and the leading type of emphysema was identical to CT in 68%, 55% and 60%, for T2-HASTE, T1-VIBE and T1-ce-VIBE respectively. A bronchial wall thickening was found in 43 lobes in CT and was correctly seen in MRI in 42%, 33% and 26%. Of those 74 lobes presented with fibrotic changes in CT were correctly identified by MRI in 39%, 35% and 58%. Small nodules were mostly underdiagnosed in MRI.

Conclusion

MRI matched the CT severity classification and leading type of emphysema in half of the cases. All sequences showed a similar diagnostic performance, however a combination of HASTE and ce-VIBE should be recommended.     

Use of foetal MRI in diagnosing hepatic hemangioendotheliomas: A report of four cases

Objective

To examine the appearance of foetal hepatic hemangioendotheliomas using prenatal magnetic resonance imaging (MRI) and to conclude whether MRI provides additional information to that obtained with ultrasonography (US).

Materials and methods

Four foetuses with hepatic hemangioendotheliomas were evaluated by US and MRI between 2005 and 2008. MRI was performed on four foetuses at 33 + 4, 37 + 4, 24 and 21 + 6 weeks gestation following US evaluations that demonstrated foetal abdominal tumours. The prenatal US and MRI findings were compared with the postnatal physical examination, enhancement computed tomography (CT) and serial ultrasound examinations, or with the pathology exams, retrospectively.

Results

All four foetuses showed very similar prenatal MRI findings. In each case, the foetal MRI detected an isolated vascular hepatic tumour with low T1 and inhomogeneous high T2 signal intensity. In one case, multiple scalp hemangiomas were detected in the postnatal physical examination, but not with the prenatal US and MRI exams. In the other three cases, the prenatal US and MRI findings were in complete agreement with the postnatal diagnoses.

Conclusion

Prenatal MRI is effective in the assessment of foetal hepatic hemangioendotheliomas. Prenatal MRI may provide a useful adjunct to US in assessing foetal hepatic tumours.     

Wrist injuries in young adults: The diagnostic impact of CT and MRI

Purpose

To evaluate the diagnostic impact of MRI or/and multidetector CT in young patients with wrist injury and inconclusive or negative clinical examination and X-rays and to analyze variations in imaging strategies between a district general hospital (GH) and a university hospital (UH).

Materials and methods

A retrospective analysis of 34 young patients (mean age 23 years) with wrist trauma who underwent CT or/and MRI was performed. The injury was acute in 24, and chronic in 10 patients. Twenty-two patients were from a GH and 12 from a UH. Two experienced musculoskeletal radiologists blindly reviewed the imaging studies. The effect of cross-sectional imaging on patient care and treatment plan was evaluated.

Results

In 9 of 34 patients one or more fractures were diagnosed on cross-sectional imaging. The scaphoid was fractured in four patients, the lunate and/or the trapezium in three patients, the scaphoid together with the lunate in one patient, and finally the distal radius in one patient. Ligamentous trauma was identified solely on MRI in 11 patients (involving the TFCC in eight cases). In four patients with both imaging methods, CT revealed one fracture of the trapezium not seen on MRI, and one scapholunate fracture with MRI findings of distal radial fracture only. In two patients with normal CT, MRI revealed bone marrow oedema of the scaphoid in one and of the distal radius, lunate and triquetrum in the other.

Conclusion

Both CT and MRI might be considered in patients with acute or chronic wrist injury, clinical dilemma and normal initial radiographs, depending on the availability and the individual institution policies.     

Improving the image quality of contrast-enhanced MR angiography by automated image registration: A prospective study in peripheral arterial disease of the lower extremities

Objective

If a patient has moved during digital subtraction angiography (DSA), manual pixel shift can improve the image quality. This study investigated whether such image registration can also improve the quality of contrast-enhanced magnetic resonance angiography (MRA) in patients with peripheral arterial disease of the lower extremities.

Materials and methods

404 leg MRAs of patients likely to have peripheral artery disease were included in this prospective study. The standard non-registered MRAs were compared to automatically linear, affine and warp registered MRAs by four image quality parameters, including the vessel detection probability (VDP) in maximum intensity projection (MIP) images and contrast-to-noise ratios (CNR). The different registration types were compared by analysis of variance.

Results

All studied image quality parameters showed similar trends. Generally, registration improved the leg MRA quality significantly (P < 0.05). The 12% of lower legs with a body shift of 1 mm or more showed the highest gain in image quality when using linear registration instead of no registration, with an average VDP gain of 20-49%. Warp registration improved the image quality slightly further.

Conclusion

Automated image registration can improve the MRA image quality especially in the lower legs, which is comparable to the effect of pixel shift in DSA.     

Observer variation of magnetic resonance imaging and diffusion weighted imaging in pelvic lymph node detection

Aim

Conventional MRI and the recently developed diffusion weighted imaging (DWI) technique both are being used for the detection of pelvic lymph node metastasis in gynaecologic cancers. Little is known about the reproducibility of DWI. This study assesses the reproducibility of pelvic lymph node detection by conventional MRI and DWI.

Materials and methods

17 patients with gynaecological malignancies eligible for curative surgery were selected as population of interest. They had undergone preoperative conventional MRI and DWI on a 3.0 T MR scanner. All images were evaluated by two experienced radiologists. Inter- and intra-observer agreements were assessed, and whether lymph node size and region were related to reproducibility. Differences were tested by Chi-square statistics.

Results

The reproducibility ranged between 42% and 65% for the two observers and for the two imaging tests, conventional MRI and DWI. Higher percentages of agreement were found for larger lymph nodes, i.e. for long as well as short axis diameter exceeding 5 mm. Also, agreement was better for lymph nodes in the external iliac region and the obturator region compared to detection of lymph nodes in the common iliac area. Results for the newer technique, DWI, were comparable to the results of the more conventional MRI sequences.

Conclusion

Reproducibility of MRI and DWI in the detection of pelvic lymph nodes in patients with a gynaecological malignancy was similar. For lymph nodes exceeding 5 mm in both long and short axis diameter the agreement was considerably better than for smaller nodes.     

Evaluation of acquired cholesteatoma with PROPELLER diffusion imaging

Purpose

Was to evaluate the role of periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) diffusion imaging in evaluation of middle ear acquired cholesteatomas (primary and recurrent) and differentiating them from middle ear granulation tissue.

Patients and methods

Forty two patients with suggested acquired cholesteatomas were included in this prospective study, they underwent spiral CT and MRI (PROPELLER diffusion) for all. The two radiologist analyzed the imaging data of plain spiral CT and PROPELLER diffusion MR images. Sensitivity and specificity were assessed. Results were compared with endoscopic and surgical results, which were regarded as the standard reference.

Results

Ten patients had middle ear granulation tissue, 21 patients had acquired primary cholesteatomas, and 11 patients had acquired recurrent (post operative) cholesteatomas. PROPELLER diffusion MR successfully diagnosed and differentiated between granulation tissue and cholesteatomas (primary and recurrent. Sensitivity (lesions detection) and specificity (lesions characterization) of PROPELLER diffusion MR was 100%. In recurrent cholesteatomas, plain CT detected abnormal densities without any differentiation resulting in 0% specificity while in primary cholesteatomas, CT successfully diagnosed them based on associated bone erosions/destruction.

Conclusion

PROPPLER diffusion Imaging is both sensitive and specific for detection and characterization of primary and recurrent cholesteatomas as it lack susceptibility and chemical-shift artifacts, and ghosts in the phase-encoding direction which occur in Echo-planar diffusion, it can detect small cholestatoma as 3 mm. It provides the highest sensitivity, specificity for detection and characterization of acquired cholesteatomas.     

Siliconomas mimicking cancer

Introduction

Silicone breast implants are widely used for breast augmentation and breast reconstruction following mastectomy. Implant rupture has specific radiological signs. With the advent use of new imaging technique such as positron emission tomography (PET) computed tomography (CT) and magnetic resonance imaging (MRI) of the breast, these signs may simulate malignancy.

Patients and methods

We retrospectively reviewed four cases of patients with silicon breast implants who arrive to the mammography clinic for further evaluation of a suspected malignant process demonstrated on either PET CT or breast MRI.

Results

Two cases were of PET CT performed for routine oncology follow-up of breast cancer. On both, the PET CT demonstrated multiple-spread benign silicone granulomas manifesting as multiple masses having an increase fluorodeoxyglucose (FDG) uptake. One case of a new mass was demonstrated as a suspicious mass on the dynamic sequences on MRI of the breast. Ultrasound-guided biopsy demonstrated benign tissue response to silicone. One case demonstrated bilateral ruptured breast implants on breast MRI, as well as bilateral axillary and mediastinal lymphadenopathy. Eventually, the patient underwent bronchoscopy for pulmonary workup of dry cough, revealing sarcoidosis.

Conclusion

Silicone granulomas can manifest as masses with suspicious morphology and enhancement dynamics on breast MRI or with increased FDG uptake on PET CT. The presence of silicone implants and awareness of the possibility of a rupture and formation of silicone granulomas may help in facilitating a correct diagnosis.     

Radiological and clinical outcome after operations in patients with congenital deficiencies of the wrist and hand

Purpose

To evaluate the incidence, therapy results, complications and radiologic workup of operatively treated congenital disorders of the hand and wrist in a large university center during a 10-year period.

Methods

The institutional database was retrospectively analysed for patients with congenital disorders of the hand and wrist treated operatively during a 10-year period (1998-2007). Disorders were classified according to Van Schoonhoven into 11 different entities. For each entity the incidence, the patients’ age at the time of operation, the pre- and postoperative clinical and radiological workup and the frequency of complications and reoperations were evaluated.

Results

A total of 278 patients was treated operatively for congenital disorders of the hand and wrist with syndactyly being present in 112, thumb hypoplasia in 15, polydactyly in 11, radial clubhand in 7, radioulnar synostosis in 6, clinodactyly in 6, thumb duplication in 6, brachydactyly in 4 and macrodactyly in 4 cases. Patients’ age at the time of operation varied substantially between the different entities with a mean age between 0.9 and 6.2 years. There were 9 complications (3%, n = 278) - all of them infections. There were 28 reoperations (10%, n = 278), 13 of them (5%, n = 278) due to reoccurring webs in syndactyly.

Conclusion

Congenital disorders of the hand and wrist include various rare diseases with syndactyly and thumb hypoplasia being the most frequent entities. As a rule, diagnosis is obtained clinically. Radiologic workup typically consists of plain radiography. Complications are rare, whereas reoperations are frequent, mostly due to reoccurring webs in syndactyly.     

CT-guided pericardiocenteses: Clinical profile, practice patterns and clinical outcome

Objective

To assess the effectiveness and clinical outcome and technique of CT-guided pericardiocenteses in the treatment of pericardial effusions in adults and children.

Methods

20 drainages were performed in Seldinger-technique under CT-guidance on 20 patients suffering from pericardial effusions and haematomas. In 85%, the etiology of effusion was postoperative.The mean age of the patients was 59 years (minimum 9 years, maximum 86 years).There were 12 male and eight female patients. The inclusion criterion was an echocardiographically relevant proved pericardial effusion.

Results

All catheters could be placed successfully (20/20) in the pericardial effusion and allowed for draining of the effusion in all cases under CT-guidance. The overall 30-day mortality rate was 0%. CT-guided pericardiocentesis was successful for withdrawing pericardial fluid and/or relieving tamponade in 100% of all procedures. No major complication was occurred. A total of one minor complication (5%) occurred that required no specific interventions, except for monitoring and appropriate follow-up. We observed one pneumothorax as a minor complication.

Conclusions

Pericardial effusions of various causes can be safely, effectively, and quickly managed with CT-guided pericardiocenteses in adults and children. The ventrolateral entry side for the puncture should be preferred to reach the whole effusion and avoid complications, like a pneumothorax.     

The efficacy of intraperitoneal saline infusion for percutaneous radiofrequency ablation for hepatocellular carcinoma

Objective

To evaluated the efficacy and safety of radiofrequency ablation (RFA) with intraperitoneal saline infusion.

Background

Ultrasound-guided RFA is not always feasible due to the tumor location, possible adjacent tissue damage or poor sonographic identification.

Patients and methods

Ultrasound-guided RFA with intraperitoneal saline infusion was performed in 116 patients between June 2001 and March 2008.

Results

The overall technical feasibility of the intraperitoneal saline infusions was 90.5% (105 patients). The purposes of the intraperitoneal saline infusion were achieved in 100 patients (86.2%) by visualizing the tumor located in hepatic dome (47 patients), prevent adjacent organ damage (42 patients) and withdrawing overlying omentum (10 patients). Complete ablation of tumor was accomplished in 102 patients (87.9%). Complications associated with the treatment occurred in seven patients (6.0%). There was no case of adverse event directly related to intraperitoneal saline infusion.

Conclusions

Intraperitoneal saline infusion is an effective and safe procedure that can be used to overcome the current limitations of ultrasound-guided RFA.     

Small vestibular schwannomas can cause gait instability

Purpose

To confirm whether detailed gait analysis can detect gait instability in patients with small vestibular schwannoma (VS) with an apparently normal gait.

Methods

Twenty-two patients (7 males, 15 females; 40-64 years old) with small VS and nine healthy age- and weight-matched controls were enrolled. Small VS was defined as the longest diameter less than 20 mm from the porus acusticus internus on MRI with no brainstem compression. Each subject was asked to walk straight for a distance of 8 m with tactile sensors attached to both feet, and repeat two trials with eyes open and closed. Gait variables of stance, swing, double support, stability, and average length of the trajectories of the center of force (TCOF) during stance were recorded and analyzed.

Results

No significant differences in the stability of the TCOF were found during gaits with eyes open and closed between the two groups. No obvious changes in gait variables were recognized with eyes open between the two groups. However, under gait with eyes closed, the values of the coefficient of variation (CV) of the gait phase were significantly greater in stance and swing in the VS group than in the normal group. In addition, patients with canal paresis (CP) showed greater CV values in gait phase related parameters than those who without CP during gait with eyes closed.

Conclusions

Patients with small VS may have an apparently normal gait, but their vestibular deficit could be detected by proper use of gait analysis, especially with visual deprivation.     

Incidental extracolonic findings on bright lumen MR colonography in a population at increased risk for colorectal carcinoma

Purpose

Incidental extracolonic findings affect patient treatment and cost. Therefore, to consider magnetic resonance colonography (MRC) as a tool for colorectal cancer and polyps screening, more knowledge is needed on extracolonic findings. In this study, we sought to determine the prevalence and the spectrum of extracolonic findings in patients with an increased risk colorectal cancer that underwent bright lumen MRC.

Materials and methods

MRC examinations were performed in 210 patients. A gadolinium solution was administered rectally for distension of the colon. Extracolonic findings were scored by two radiologists and classified by using C-RADS Reporting System. All findings (with advice regarding work-up) were reported to the patient's physician and followed up for 4.5 years on average.

Results

Extracolonic findings were found in 125 (59.5%) patients. Ten (4.8%) had “potentially important” findings (C-RADS category E4). Twenty-five patients (11.9%) had “likely unimportant” findings (E3), 90 (42.8%) had “clinically unimportant” findings (E2) and 85 (40.5%) had a normal exam (E1). In 14 (6.7%) patients additional work-up was performed for their incidentally discovered lesions. In three of them surgery was performed. After work-up, only in two (1.0%) patients a malignancy was found.

Conclusion

The number of new relevant extracolonic findings is small and the required additional work-up is limited. This should be considered for implementation of ‘bright lumen’ MRC as a screening tool.     

Ileal Crohn's disease: MRI with endoscopic correlation

Purpose

To evaluate activity staging of Crohn's disease (CD) measured with MR-enterography using ileoscopy as reference standard.

Materials and methods

A prospective study was made of 61 patients with CD. All patients underwent MR-enterography and ileoscopy. MRI activity was measured by means of an ad hoc developed score, as well as by analysis of the imaging findings, and was compared with the SES-CD score obtained via ileoscopy. Examinations were performed using a 1.0 T scanner.

Results

MRI score discriminates between active and inactive disease with an area under the ROC curve of 0.941. Overall correlation with the standard reference SES-CD score was moderate to strong (Spearman's r = 0.62 p < 0.001).Agreement between both methods in staging patients with ileal CD as inactive, mild or moderate to severe was good (Cohen's κ = 0.60). Differences in means of the MRI activity scores of the three groups showed statistical significance (p < 0.01).

Conclusions

The MRI score is a reliable predictor of activity in ileal CD and can stage patients in a way comparable to endoscopy. 1.0 T scans are valid for performing radiological evaluation of ileal Crohn's disease.     

Comparison of the manual and computer-aided techniques for evaluation of wrist synovitis using dynamic contrast-enhanced MRI on a dedicated scanner

Objective

Traditional methods for assessment of synovial inflammation in rheumatoid arthritis such as clinical examination, immunohistology of bioptic samples, scintigraphy, and radiography have several limitations, including lack of sensitivity, need of invasive techniques, and administration of radioactive material. MRI lacks on standardisation and the data are often analysed using laborious, relatively rigid scoring methods.

Materials and methods

This study introduces a standardized computer-aided method for quantitative analysis of MRI of the wrist on a dedicated scanner. Assessment of the synovial inflammation was performed using a semi-automated model-based method in conjunction with patient motion reduction algorithms. Further, the new method was compared with the traditional user-dependent ROI-based technique.

Results

The computer-aided technique generated robust and reproducible results. Application of motion reduction algorithms allowed for significant improvements of the signal to noise ratio, which is especially important in the datasets acquired with low-field scanners.

Conclusion

The use of the computer software can be beneficial for diagnostic decision in cross sectional as well as longitudinal MRI examinations of the wrist in rheumatoid arthritis.     

Do all mucocele-like lesions of the breast require surgery?

Aim

The objective of this study is to review the imaging features and percutaneous biopsy findings of mucocele-like lesions (MLLs) of the breast and correlate these with histopathology at surgical excision (SE), where available, to determine whether all MLLs of the breast require surgery for management.

Materials and Methods

A search of two pathology databases was performed to identify 44 patients who had been diagnosed with MLL of the breast and who had corresponding imaging findings available for review. These patients' medical records were reviewed to determine patient age at diagnosis, site of disease/affected breast, symptoms at diagnosis, mammographic and sonographic findings and methods used for histopathologic diagnosis (percutaneous biopsy and/or SE).

Results

The mean age of all patients was 56 years (range, 35-76 years). Sixteen patients had MLLs diagnosed by core needle biopsy (CNB) or fine needle aspiration biopsy followed by SE. Eighteen patients had CNB without SE and had clinical and imaging follow-up. Ten patients had MLL diagnosed at SE without prior percutaneous biopsy. In total, 29 patients (66%) had MLLs without atypia, while 10 patients had MLLs associated with atypical ductal hyperplasia (ADH) (23%) and five patients had MLLs associated with ductal carcinoma in situ (DCIS) (11%). Findings were upgraded at SE following the percutaneous biopsy from ADH to DCIS in 19% (3/16) of patients.

Conclusion

Surgical excision following the identification of MLL is warranted to exclude coexisting in situ carcinoma in specific situations where CNB detects the presence of associated ADH or where a mass with indistinct or irregular margins is shown by mammography or sonography.     

CT and MR imaging characteristics of infantile hepatic hemangioendothelioma

Aim

This study aims to analyze computed tomography (CT) and magnetic resonance (MR) imaging features of infantile hepatic hemangioendotheliomas before and after treatment.

Materials and methods

CT and MR examinations of seven infants with biopsy proven hepatic hemangioendotheliomas were retrospectively analyzed. The distribution, number, size, imaging appearance, enhancement pattern and post-treatment changes of the tumors were evaluated.

Results

A total of 153 hepatic hemangioendotheliomas were detected on CT (111) and MR (42) imaging. In six infants, 109/111 (98.2%) tumors were hypodense and 2/111 (1.8%) lesions contained calcification on unenhanced CT. On MR imaging, all 42 lesions in one infant were heterogeneously T1-hypointense and T2-hyperintense compared to the normal liver parenchyma. Contrast-enhanced CT and MRI showed peripheral rim (51.6%), uniform (48.4%), fibrillary (33.3%), and nodular (28.8%) contrast enhancement in the hepatic arterial phase. Homogeneous (100%), rim (98.2%) and mixed enhancement patterns were noted in tumors <1.0 cm, >2.0 cm and 1.0-2.0 cm in diameter respectively in the hepatic arterial phase. In three patients who underwent steroid therapy, follow-up CT examination demonstrated tumor size reduction and increased intra-tumoral calcification in two patients.

Conclusion

Infantile hepatic hemangioendotheliomas show some typical imaging features and size-dependent pattern of contrast enhancement on CT and MR imaging, which allow accurate imaging diagnosis and post-treatment evaluation.