Comparison of the clinical and MRI features of patients with hepatic hemangioma, epithelioid hemangioendothelioma, or angiosarcoma

Abstract Background Comparisons of hepatic epithelioid hemangioendothelioma (HEHE), hepatic hemangioma, and hepatic angiosarcoma (HAS) have rarely been reported. The purpose of our study was to analyze the clinical and magnetic resonance imaging (MRI) findings of these conditions. Methods A total of 57 patients (25 with hemangioma, 13 with HEHE, and 19 with HAS) provided hepatic vascular endothelial cell data between June 2006 and May 2017. Results The proportions of cases with circumscribed margins were 88% (22/25), 84.6% (11/3), and 31.6% (6/19) for hemangioma, HEHE, and HAS, respectively (P<0.001). HAS lesions were less likely to have circumscribed margins. The proportions of lesions with hemorrhaging were 4% (1/25), 44.4% (4/13), and 36.8% (7/13) for hemangioma, HEHE, and HAS, respectively (P=0.014). HEHE and HAS cases were more likely to show heterogeneous signals on T1-weighted (T1WI) MRI. HEHE and HAS cases were more likely to show heterogeneous signals on T2-weighted (T2WI) MRI. Centripetal enhancement was the most common pattern in vascular tumors, with proportions of 100%, 46.2% (6/13), and 68.4% (13/19) for hemangioma, HEHE, and HAS, respectively. The difference in enhancement pattern between HEHE and HAS was not significant, but rim enhancement was more common for HEHE (46.2%, 6/13). Conclusions Our study revealed clinical and imaging differences between HEHE and HAS. The platelet count (PLT) and coagulation function of the HAS group decreased, whereas the alpha-fetoprotein (AFP) level increased. The 5-year survival rate for HAS was significantly lower than that of HEHE. A higher malignancy degree indicated a more blurred lesion margin, easier occurrence of hemorrhaging, and more heterogeneous plain T1WI and T2WI signals.

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Comparison of the clinical and MRI features of patients with hepatic hemangioma, epithelioid hemangioendothelioma, or angiosarcoma

10.21203/rs.2.16278/v1 ◽

2019 ◽

Author(s):

Zhuangsheng Liu ◽

Lilei Yi ◽

Junhao Chen ◽

Ruqiong Li ◽

Keming Liang ◽

...

Keyword(s):

Vascular Endothelial Cell ◽

Measurement Data ◽

Epithelioid Hemangioendothelioma ◽

Vascular Tumors ◽

Hepatic Hemangioma ◽

Mri Findings ◽

Mri Features ◽

Rim Enhancement ◽

The Difference ◽

Magnetic Resonance Imaging Mri

Abstract Background Comparisons of hepatic epithelioid hemangioendothelioma (HEHE), hepatic hemangioma, and hepatic angiosarcoma (HAS) have rarely been reported. The purpose of our study was to analyze the clinical and magnetic resonance imaging (MRI) findings of these conditions.Methods A total of 57 patients (25 with hemangioma, 13 with HEHE, and 19 with HAS) provided hepatic vascular endothelial cell data between June 2006 and May 2017. The measurement data were represented as means±SDs. Between-group comparisons were performed using independent-samples t-tests. Count data were represented as frequencies or rates, and χ2- or Fisher’s exact tests were performed.Results The proportions of cases with circumscribed margins were 88% (22/25), 84.6% (11/3), and 31.6% (6/19) for hemangioma, HEHE, and HAS, respectively (P<0.001). HAS lesions were less likely to have circumscribed margins. The proportions of lesions with hemorrhaging were 4% (1/25), 44.4% (4/13), and 36.8% (7/13) for hemangioma, HEHE, and HAS, respectively (P=0.014). HEHE and HAS cases were more likely to show heterogeneous signals on T1-weighted (T1WI) MRI. HEHE and HAS cases were more likely to show heterogeneous signals on T2-weighted (T2WI) MRI. Centripetal enhancement was the most common pattern in vascular tumors, with proportions of 100%, 46.2% (6/13), and 68.4% (13/19) for hemangioma, HEHE, and HAS, respectively. The difference in enhancement pattern between HEHE and HAS was not significant, but rim enhancement was more common for HEHE (46.2%, 6/13).Conclusions Our study revealed clinical and imaging differences between HEHE and HAS. The platelet count (PLT) and coagulation function of the HAS group decreased, whereas the alpha-fetoprotein (AFP) level increased. The 5-year survival rate for HAS was significantly lower than that of HEHE. A higher malignancy degree indicated a more blurred lesion margin, easier occurrence of hemorrhaging, and more heterogeneous plain T1WI and T2WI signals.

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Cerebral schistosomiasis: MRI features with pathological correlation

Acta Radiologica ◽

10.1177/0284185120934475 ◽

2020 ◽

pp. 028418512093447

Author(s):

Chun-yan Lu ◽

Sha Zhao ◽

Yi Wei

Keyword(s):

Magnetic Resonance Imaging ◽

Brain Area ◽

Pathological Findings ◽

Resonance Imaging ◽

Mri Findings ◽

Mri Features ◽

Cerebral Involvement ◽

Magnetic Resonance Imaging Mri ◽

The Brain ◽

Radiology And Pathology

Background Neuroschistosomiasis is not commonly encountered and is probably underrecognized. We hope these findings can help clinicians and radiologists to raise awareness of this disabling disorder. Purpose To demonstrate the magnetic resonance imaging (MRI) findings of cerebral schistosomiasis and correlate it with pathological findings. Material and Methods We identified seven patients with cerebral schistosomiasis from radiology and pathology archives of our hospital. Of the seven patients, six were pathologically confirmed. The remaining patient had pathologically confirmed spinal schistosomiasis with MRI findings of cerebral involvement. MRI and pathological findings of these patients were analyzed and correlated. Results Multiple enhancing nodules at varying size were found in all patients. Prominent leptomeningeal or choroidal veins were found in six patients, four at the center of the foci and two at the periphery. Hemorrhage was identified in two patients. Histology revealed granulomas around ova in six patients. A prominent vein with ova in the lumen and wall of a vein was found in one patient and perivascular ova deposition was found in one patient. Conclusion Multiple enhancing nodules with central or peripheral veins in a circumscribed brain area are important signs to the diagnosis of cerebral schistosomiasis. The inflamed veins involved may be the route taken by the ova to spread to the brain tissue.

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Diverse MRI findings and clinical outcomes of acute Marchiafava-Bignami disease

Acta Radiologica ◽

10.1177/0284185120943040 ◽

2020 ◽

pp. 028418512094304

Author(s):

Wei Li ◽

Chao Ran ◽

Jun Ma

Keyword(s):

Clinical Outcomes ◽

Clinical Manifestations ◽

Acute Onset ◽

Restricted Diffusion ◽

Type I ◽

Type Ii ◽

Mri Findings ◽

Type Iii ◽

Mri Features ◽

Magnetic Resonance Imaging Mri

Background The acute onset of Marchiafava-Bignami disease (MBD) is difficult to capture, and its clinical manifestations are overlapped. Magnetic resonance imaging (MRI) is very useful in the diagnosis of acute MBD. Purpose To investigate the MRI features and clinical outcomes of acute MBD. Materials and Methods Sagittal T2-weighted (T2W) or T1-weighted (T1W) imaging, axial T1W and T2W imaging, and axial FLAIR and diffusion-weighted imaging (DWI) sequences were performed in 17 patients with acute MBD on 1.5-T MR. According to the different ranges of callosal restricted diffusion, MBD was divided into Type I (n = 7, the completely involved), Type II (n = 5, the mostly involved), and Type III (n = 5, the partly involved). The MRI findings and outcomes of each type were retrospectively analyzed. Results With the reduced range of the callosal restricted diffusion, the callosal atrophy or cavitation was more common: no case of Type I; 1 (20%) case of Type II; and 3 (60%) cases of Type III. With the increased range of callosal restricted diffusion, the extracallosal involvement was more common: 6 (86%) cases of Type I; 3 (60%) cases of Type II; and 1 (20%) case of Type III. During the follow-up, five cases had neuropsychiatric sequelae: 1 (14%) case of type I; 1 (20%) case of Type II; 3 (60%) cases of Type III. Conclusion The MRI findings and clinical outcomes of acute MBD are regular. The extensive restricted diffusion of acute MBD may present the curable condition. Callosal heterogeneity may affect the outcome of acute MBD.

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The Relationship Between Gastrointestinal Comorbidities, Clinical Presentation and Surgical Outcome in Patients with DCM: Analysis of a Global Cohort

Journal of Clinical Medicine ◽

10.3390/jcm9030624 ◽

2020 ◽

Vol 9 (3) ◽

pp. 624 ◽

Cited By ~ 2

Author(s):

Aria Nouri ◽

Jetan H. Badhiwala ◽

So Kato ◽

Hamed Reihani-Kermani ◽

Kishan Patel ◽

...

Keyword(s):

Surgical Outcome ◽

Neurological Impairment ◽

International Studies ◽

Mri Features ◽

Intensity Changes ◽

The Difference ◽

Magnetic Resonance Imaging Mri ◽

T2 Hyperintensity ◽

Neck Disability ◽

Degenerative Cervical Myelopathy

Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord impairment in adults, presenting most frequently in patients 50 years or older. Gastrointestinal comorbidities (GICs) commonly occur in this group; however, their relationship with DCM has not been thoroughly investigated. It is the objective of the present study to investigate the difference between patients with or without GICs who are surgically treated for DCM. A cohort of 757 patients with clinical data and 458 with magnetic resonance imaging (MRI) data from the AOSpine North America and AOSpine International studies on DCM was evaluated. GICs were obtained at presentation and included gastric, intestinal, hepatic, and pancreatic conditions. Patients were dichotomized into 2 groups: those with GICs and those without GICs. Both clinical and MRI presentation, as well as baseline neurological and functional status, were compared. Neurological and functional outcomes at 2-year follow-up were also compared. GICs were present in 121 patients (16%). These patients were less commonly male (48.76% vs. 65.4%, p = 0.001) and were slightly less neurologically impaired based on the Nurick grade (3.05 ± 1.10 vs. 3.28 ± 1.16, p = 0.044) but not based on mJOA (12.74 ± 2.62 vs. 12.48 ± 2.76, p = 0.33). They also had a worse physical health score (32.80 ± 8.79 vs. 34.65 ± 9.38 p = 0.049), worse neck disability (46.31 ± 20.04 vs. 38.23 ± 20.44, p < 0.001), a lower prevalence of upper motor neuron signs (hyperreflexia, 70.2% vs. 78.9%, p = 0.037; Babinski’s sign 24.8% vs. 37.3%, p = 0.008), and a higher rate of psychiatric comorbidities (31.4% vs. 10.4%, p < 0.0001). On MRI, GIC patients less commonly exhibited signal intensity changes (T2 hyperintensity, 49.2% vs. 75.6%, p < 0.001; T1 hypointensity, 9.7% vs. 21.1%, p = 0.036), and had a lower number of T2 hyperintensity levels (0.82 ± 0.98 vs. 1.3 ± 1.11, p = 0.001). There was no difference in surgical outcome between the groups. DCM patients with GICs are more likely to be female and have significantly more general health impairment and neck disability. However, these patients have less clinical and MRI features typical of more severe neurological impairment. This constellation of symptoms is considerably different than those typically observed in DCM, and it is therefore plausible that nutritional factors may contribute to this unique observation.

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The utility of dynamic MRI in differentiating the hormone-producing ability of pituitary adenomas

Japanese Journal of Radiology ◽

10.1007/s11604-021-01121-9 ◽

2021 ◽

Author(s):

Taishi Amano ◽

Tomohiko Masumoto ◽

Hiroyoshi Akutsu ◽

Noriaki Sakamoto ◽

Sodai Hoshiai ◽

...

Keyword(s):

Pituitary Adenomas ◽

Dynamic Mri ◽

Thyroid Stimulating Hormone ◽

Washout Rate ◽

Mri Findings ◽

Mean Values ◽

Mri Features ◽

Magnetic Resonance Imaging Mri ◽

The Relationship ◽

Tissue Enhancement

Abstract Purpose To investigate the relationship between dynamic magnetic resonance imaging (MRI) findings and hormonal activity in pituitary adenomas. Methods We retrospectively evaluated the dynamic MRI findings in 244 patients with pathologically confirmed pituitary adenomas and a diagnosis of clinically active prolactin (PRL)-producing adenomas. Among the 244 pituitary adenomas, 55, 16, 6, and 4 produced growth hormone (GH), PRL, adrenocorticotropic hormone, and thyroid-stimulating hormone, respectively, while 163 were non-functioning (NF) adenomas. For each adenoma, we calculated the washout rate (WR) and early (EER) and delayed (DER) tumour-to-normal-tissue enhancement ratios. Results The respective mean values of the WR, EER, and DER were 9.4%, 75.2%, and 64.5% for GH-producing adenomas; 6.2%, 117.1%, and 106.2% for PRL-producing adenomas; and 5.4%, 116.7%, and 108.7% for NF adenomas. GH-producing adenomas had significantly lower EER and DER values than PRL-producing (P < 0.001) and NF adenomas (P < 0.001). In ROC analysis of GH-producing and non-GH-producing adenomas, the areas under the curves of WR, EER, and DER were 0.593, 0.825, and 0.857, respectively. Conclusion There are differences in dynamic MRI features between GH-producing and non-GH-producing adenomas, which suggests that EER and DER may be useful for diagnosing GH-producing adenomas.

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Comparison of the clinical and MRI features of patients with hepatic hemangioma, epithelioid hemangioendothelioma, or angiosarcoma

BMC Medical Imaging ◽

10.1186/s12880-020-00465-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Zhuangsheng Liu ◽

Lilei Yi ◽

Junhao Chen ◽

Ruqiong Li ◽

Keming Liang ◽

...

Keyword(s):

Epithelioid Hemangioendothelioma ◽

Hepatic Hemangioma ◽

Mri Features

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Magnetic Resonance Imaging in Cavitary Choroidal Melanoma

European Journal of Ophthalmology ◽

10.1177/112067210001000412 ◽

2000 ◽

Vol 10 (4) ◽

pp. 335-337 ◽

Cited By ~ 3

Author(s):

G. Rebolleda ◽

M. Suárez Figueroa ◽

F.J. Muñoz-Negrete ◽

A. Rocamora

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Choroidal Melanoma ◽

Solid Mass ◽

Resonance Imaging ◽

Mri Findings ◽

Nevus Of Ota ◽

Spindle Cells ◽

Mri Features ◽

Magnetic Resonance Imaging Mri

Purpose To report the development of a cavitary choroidal melanoma in a patient with nevus of Ota and describe its magnetic resonance imaging (MRI) features. Patient A 66-year-old man with right oculodermal melanocytosis and an ipsilateral choroidal cavitary melanoma was seen. Diagnosis was suspected on the clinical, ultrasonographic and MRI findings. Results T1-weighted image showed a hyperintense solid mass containing hypointense cystic-like spaces delineated by hyperintense septa with respect to the vitreous. The reverse image was observed on T2-weighted images. A choroidal melanoma comprising epithelioid and spindle cells with multilocular cavities was documented histopathologically. Conclusions There may be an association between cavitary melanoma and nevus of Ota. Characteristic MRI findings could be helpful in the differential diagnosis of cavitary uveal melanoma.

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Dermatomal Somatosensory Evoked Potentials And Cortical Somatosensory Evoked Potentials Assessment In Congenital Scoliosis

10.21203/rs.3.rs-647962/v1 ◽

2021 ◽

Author(s):

Zhenxing Zhang ◽

Yi Wang ◽

Tao Luo ◽

Yang Yuan ◽

Jingfeng Li

Keyword(s):

Evoked Potentials ◽

Somatosensory Evoked Potentials ◽

Clinical Symptoms ◽

Congenital Scoliosis ◽

Mri Findings ◽

Routine Clinical Examination ◽

The Difference ◽

Magnetic Resonance Imaging Mri ◽

Spinal Cord Function ◽

Baseline Examination

Abstract Background: The aim of this study was to assess the value of dermatomal somatosensory evoked potentials (DSEPs) and cortical somatosensory evoked potentials (SSEPs) in monitoring spinal cord function for patients with congenital scoliosis (CS). Methods: This study retrospectively analyzed the neurophysiological signals recorded in 62 patients from our orthopedic department who underwent MRI, CT and a specialist physical examination by a surgeon to confirm the diagnosis of CS. To observe the incidence of abnormal DSEPs and SSEPs in CS patients and to analyze the difference in sensitivity and reliability between the two in the examination of scoliosis patients. Results: All patients were evaluated with total spine magnetic resonance imaging (MRI). Only 23 patients (37.09%) showed intradural lesions in the MRI findings. Abnormal waveforms were observed in the DSEPs of 60 patients (96.8%) , 25 of which (40.3%) had abnormal waveforms in the tibial SSEPs, and the difference was statistically significant (P＜0.05). Of the 10 patients with clinical symptoms, 2 (20%) had abnormal tibial SSEPs waveforms , and 23 (44.2%) of 52 patients without clinical symptoms had abnormal tibial SSEPs waveforms. DSEPs are more sensitive to microscopic posterior column dysfunction in patients with CS that cannot be detected by either imaging or routine clinical examination. Conclusion: DSEPs provide evidence for the type of neurophysiological dysfunction in patients with congenital scoliosis. Preoperative DSEPs assessment is recommended as a baseline examination for intraoperative monitoring and comparison with the postoperative situation. DSEPs recording complements the information obtained from routine clinical and radiological evaluation.

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4H Leukodystrophy: Lessons from 3T Imaging

Neuropediatrics ◽

10.1055/s-0037-1608780 ◽

2017 ◽

Vol 49 (02) ◽

pp. 112-117 ◽

Cited By ~ 6

Author(s):

Ferdy Cayami ◽

Marianna Bugiani ◽

Petra Pouwels ◽

Geneviève Bernard ◽

Marjo van der Knaap ◽

...

Keyword(s):

White Matter ◽

Clinical Symptoms ◽

Hypogonadotropic Hypogonadism ◽

Medial Lemniscus ◽

Imaging Data ◽

Mri Findings ◽

Mri Features ◽

Mri Diagnosis ◽

Magnetic Resonance Imaging Mri ◽

Hypointense Signal

Abstract4H leukodystrophy is characterized by hypomyelination, hypodontia, and hypogonadotropic hypogonadism. With its variability in clinical symptoms, application of pattern recognition to identify specific magnetic resonance imaging (MRI) features proved useful for the diagnosis. We collected 3T MR imaging data of 12 patients with mutations in POLR3A (n = 8), POLR3B (n = 3), and POLR1C (n = 1), all obtained at the same scanner. We assessed these images and compared them with previously obtained 1.5T images in 8 patients. Novel MRI findings were myelin islets, closed eye sign, and a cyst-like lesion in the splenium. Myelin islets were variable numbers of small T1 hyperintense and T2 hypointense dots, mostly in the frontal and parietal white matter, and present in all patients. This interpretation was supported with perivascular staining of myelin protein in the hypomyelinated white matter of a deceased 4H patient. All patients had better myelination of the medial lemniscus with a relatively hypointense signal of this structure on axial T2-weighted (T2W) images (“closed eye sign”). Five patients had a small cyst-like lesion in the splenium. In 10 patients with sagittal T2W images, we also found spinal cord hypomyelination. In conclusion, imaging at 3T identified additional features in 4H leukodystrophy, aiding the MRI diagnosis of this entity.

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Treatment of Hepatic Epithelioid Hemangioendothelioma: Finding Uses for Thalidomide in a New Era of Medicine

Case Reports in Gastrointestinal Medicine ◽

10.1155/2015/326795 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Matthew P. Soape ◽

Rashmi Verma ◽

J. Drew Payne ◽

Mitchell Wachtel ◽

Fred Hardwicke ◽

...

Keyword(s):

Vascular Endothelial Growth Factor ◽

Growth Factor ◽

Liver Biopsy ◽

Birth Defects ◽

Epithelioid Hemangioendothelioma ◽

Vascular Tumors ◽

Vascular Endothelial ◽

New Era ◽

Progression Of Disease ◽

Endothelial Growth Factor

Hepatic epithelioid hemangioendothelioma (HEH) is extremely rare, occurring in 1 to 2 per 100,000, with chemotherapy options not well defined. Our case involved a 49-year-old female who had hepatic masses and metastasis to the lungs with a liver biopsy revealing HEH. After developing a rash from sorafenib, thalidomide was started with the progression of disease stabilized. Resection is only an option in 10% of the cases; therefore, chemotherapy is the only line of treatment. Newer chemotherapy alternatives are targeting angiogenesis via the vascular endothelial growth factor. Thalidomide was first used as an antiemetic, but, sadly, soon linked to phocomelia birth defects. Given the mechanism of action against angiogenesis, thalidomide has a valid role in vascular tumors. In conclusion, the use of thalidomide as chemotherapy is novel and promising, especially in the setting of a rare vascular liver tumor such as HEH.

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