CT and MRI Manifestations of Primary Hepatic Angiosarcomas

Objective To investigate CT and MRI characteristic manifestations of primary hepatic angiosarcoma( PHA) in order to improve its diagnostic accuracy. Methods The clinical and imaging materials of 10 patients with pathologically-proved PHA were retrospectively analyzed. Both plain and multi-phase enhanced CT examinations were performed in all the 10 patients. Additional MRI scanning was employed in 5 patients. Results Among the 10 cases,solitary huge mass type was seen in 7,multiple nodule type in one and mixed type in two. In 4 cases with huge mass type,patchy high signal on T1WI,indicating bleeding,was demonstrated. In other three cases with huge mass type,disorderly flow-void vascular shadow on T2WI was detected. On enhanced scans,eight huge lesions showed moderate to marked peripheral inhomogeneous ring-like or irregular enhancement at arterial phase,which remained in portal and delayed phase and the central area of the lesion was not completely filled with contrast. In one case with multiple nodule type mild to moderate patchy enhancement at central area was revealed during the arterial and portal phase,and the enhancement was kept on in delayed phase. Some lesions showed no obvious enhancement in all phases. Conclusion Primary hepatic angiosarcoma carries certain CT and MRI characteristics features. Enhanced scanning plays an important role in making diagnosis of PHA. The typical imaging manifestation of PHA is moderate to marked enhancement at the peripheral and central area of the tumor during the arterial phase which remains in the portal and delayed phase,and usually in most cases the central area of the lesion can not be completely filled with the contrast.