Objective To explore magnetic resonance imaging (MRI) features and diffusion characteristics of focal peliosis hepatis (PH). Methods Clinical data and MRI images of 21 patients with pathologically confirmed focal PH treated at Zhongshan Hospital Fudan University and Weifang People’s Hospital from January 2012 to March 2024 were retrospectively analyzed. Image analysis included the number, location, size, shape, signal intensity on plain scans, dynamic enhancement characteristics, and the relationship between the lesions and adjacent blood vessels. The apparent diffusion coefficient (ADC) values of the lesions and surrounding normal hepatic parenchyma were measured and compared for statistical significance. All cases were divided into two groups based on the patients’ history of tumor chemotherapy, and the MRI manifestations of the lesions in the two groups were compared for statistical significance. Results A total of 26 lesions were identified in 21 patients, with 23 located in the right hepatic lobe and three in the left lobe. The lesions had indistinct borders, and the average diameter ranged from 7.5 to 72.0 mm (mean 25.4 ± 17.8 mm). Of these, 23 lesions exhibited slightly hypointense signal on T1-weighted imaging (T1WI), 1 lesion showed slightly hyperintense signal, and 2 lesions appeared isointense. On T2-weighted imaging (T2WI), 25 lesions showed slightly hyperintense signal, and 1 lesion was isointense. Diffusion-weighted imaging (DWI) showed either isointense or slightly hyperintense signal within the lesions. The mean ADC value of the lesions was (1.499 ± 0.397) × 10⁻3 mm2/s, while the mean ADC value of the surrounding normal liver parenchyma was (1.725 ± 0.669) × 10⁻3 mm2/s. No significant difference was found between the two (P > 0.05). On dynamic contrast-enhanced imaging, 22 lesions exhibited progressive filling enhancement, while 4 lesions demonstrated sustained significant enhancement. Vascular structures were observed as dot-like or linear signals in 10 lesions, and 3 lesions demonstrated compressed and displaced blood vessels at their margins. The lesions in the group with a history of tumor chemotherapy had an average diameter ranging from 7.5 to 38.5 mm (mean 17.7 ± 9.7 mm), which was smaller than those in the group without a history of tumor chemotherapy [ranging from 9.0 to 72.0 mm (mean 35.9 ± 21.3 mm)]. The difference in lesion size between the two groups was statistically significant (P < 0.05). Conclusion MRI manifestations of focal PH are distinctive, and the combination with diffusion-weighted imaging may assist in the diagnosis of this condition. Graphical abstract

Focal peliosis hepatis: magnetic resonance imaging manifestations and diffusion characteristics

期刊论文
发表日期：

2025年10月9日

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Zhijian Liu,
Tingting Geng,
Yuan Ji,
Mengsu Zeng,
Mingliang Wang

摘要

Objective

To explore magnetic resonance imaging (MRI) features and diffusion characteristics of focal peliosis hepatis (PH).

Methods

Clinical data and MRI images of 21 patients with pathologically confirmed focal PH treated at Zhongshan Hospital Fudan University and Weifang People’s Hospital from January 2012 to March 2024 were retrospectively analyzed. Image analysis included the number, location, size, shape, signal intensity on plain scans, dynamic enhancement characteristics, and the relationship between the lesions and adjacent blood vessels. The apparent diffusion coefficient (ADC) values of the lesions and surrounding normal hepatic parenchyma were measured and compared for statistical significance. All cases were divided into two groups based on the patients’ history of tumor chemotherapy, and the MRI manifestations of the lesions in the two groups were compared for statistical significance.

Results

A total of 26 lesions were identified in 21 patients, with 23 located in the right hepatic lobe and three in the left lobe. The lesions had indistinct borders, and the average diameter ranged from 7.5 to 72.0 mm (mean 25.4 ± 17.8 mm). Of these, 23 lesions exhibited slightly hypointense signal on T1-weighted imaging (T1WI), 1 lesion showed slightly hyperintense signal, and 2 lesions appeared isointense. On T2-weighted imaging (T2WI), 25 lesions showed slightly hyperintense signal, and 1 lesion was isointense. Diffusion-weighted imaging (DWI) showed either isointense or slightly hyperintense signal within the lesions. The mean ADC value of the lesions was (1.499 ± 0.397) × 10⁻³ mm²/s, while the mean ADC value of the surrounding normal liver parenchyma was (1.725 ± 0.669) × 10⁻³ mm²/s. No significant difference was found between the two (P > 0.05). On dynamic contrast-enhanced imaging, 22 lesions exhibited progressive filling enhancement, while 4 lesions demonstrated sustained significant enhancement. Vascular structures were observed as dot-like or linear signals in 10 lesions, and 3 lesions demonstrated compressed and displaced blood vessels at their margins. The lesions in the group with a history of tumor chemotherapy had an average diameter ranging from 7.5 to 38.5 mm (mean 17.7 ± 9.7 mm), which was smaller than those in the group without a history of tumor chemotherapy [ranging from 9.0 to 72.0 mm (mean 35.9 ± 21.3 mm)]. The difference in lesion size between the two groups was statistically significant (P < 0.05).

Conclusion

MRI manifestations of focal PH are distinctive, and the combination with diffusion-weighted imaging may assist in the diagnosis of this condition.

Graphical abstract