Hepatic hemangioma: correlation of enhancement types with diffusion-weighted MR findings and apparent diffusion coefficients

Purpose

To correlate hepatic hemangioma enhancement types in gadolinium-enhanced magnetic resonance (MR) images with diffusion-weighted MR findings and apparent diffusion coefficients (ADCs).

Materials and methods

Respiratory-triggered diffusion-weighted MR images (TR/TE, 2422/46 ms; parallel imaging factor, 2; b factor, 500 s/mm²; number of averaging, 6) obtained in 35 patients with 44 hepatic hemangiomas diagnosed by gadolinium-enhanced MR and by follow-up imaging were retrospectively evaluated. Hemangiomas were classified into three enhancement types based on gadolinium-enhanced MR imaging findings: type I, early-enhancement type; type II, peripheral nodular enhancement type; type III, delayed enhancement type. Two blinded readers qualitatively assessed lesion sizes and signal intensities on T2-weighted turbo spin-echo and diffusion-weighted images. The ADCs of hemangiomas were also measured.

Results

No significant difference was observed between the three enhancement types in terms of signal intensities on T2-weighted images. Signal intensities on diffusion-weighted images were lower in the order type I to III (P < .01), and mean ADCs were 2.18 × 10⁻³, 1.86 × 10⁻³, and 1.71 × 10⁻³ mm²/s for types I, II, and III, respectively (P < .01). No correlation was found between lesion sizes and ADCs.

Conclusion

Hepatic hemangiomas were found to have enhancement type dependent signal intensities and ADCs on diffusion-weighted MR images. Further studies will have to substantiate that these diffusion patterns might reflect intratumoral blood flow or perfusion.