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Objectives <p>The aim of this study was to describe the imaging features on dynamic CT and MRI of a series of pathologically confirmed low-grade vascular neoplasia of the liver (LGVNL).</p> Materials and methods <p>In this retrospective multicenter study, patients diagnosed with pathologically proven LGVNL between January 2014 and August 2024 and with cross-sectional imaging (CT or MRI) were included. Based on prior studies, we divided the patients into two groups: a group with typical LGVNL features and a group with atypical tumors. Univariable analysis and the logistic regression model were used to evaluate the outcome of typical and atypical LGVNL features.</p> Results <p>Twenty-eight patients were included (20 men, mean age 53.7 ± 13.4 [SD] years old). The median size of tumors at diagnosis was 22 mm [IQR, 10–80]. A typical LGVNL pattern including thick continuous peripheral arterial phase “flower petal shape” enhancement was found on MRI in 67% (18/27) with lobulated lesions (<i>p</i> = 0.001), a marked hypersignal on T2-weighted images (<i>p</i> = 0.003) and a high apparent diffusion coefficient (ADC) (mean tumor ADC, 2.1 × 10<sup>−3</sup> ± 0.3 [SD] mm<sup>2</sup>/s) (<i>p</i> = 0.006) with portal and delayed phase filling following contrast administration. An atypical LGVNL pattern was found in 33% (9/27), including homogeneous arterial phase enhancement that persisted during the portal and delayed phases. After a median follow-up of 16 months, tumor growth was observed in 42% (8/19) and was faster in patients with the atypical LGVNL pattern (<i>p</i> = 0.013).</p> Conclusion <p>The typical imaging pattern of LGVNL that includes arterial phase “flower petal shape” enhancement with a marked hypersignal on T2-weighted images and a high ADC was seen in most cases.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>Low-grade vascular neoplasia of the liver, including hepatic small vessel neoplasms and anastomosing hemangioma, is a new entity of vascular tumors with few radiological descriptions.</i></p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>Diagnostic imaging criteria include the “flower petal shape” enhancement pattern on arterial phase, a marked hypersignal on T2-weighted images and high ADC values.</i></p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>This multicenter study provides clinical, pathological and imaging data on low-grade vascular neoplasia of the liver and highlights specific imaging features for its diagnosis. Knowledge of these imaging features helps eliminate differential diagnoses.</i></p> Graphical Abstract <p></p>

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Imaging features of recently identified low-grade vascular neoplasia of the liver: hepatic small vessel neoplasm and anastomosing hemangioma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月4日

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  • Maïté Lewin,
  • Rauda Aldhaheri,
  • Aurélie Beaufrère,
  • Christophe Desterke,
  • Anita Paisant,
  • Ivan Bricault,
  • Paul Borde,
  • Gabriel Simon,
  • Mickaël Lesurtel,
  • Daniel Cherqui,
  • Clara Prud’Homme,
  • Valérie Vilgrain,
  • Astrid Laurent-Bellue

摘要

Objectives

The aim of this study was to describe the imaging features on dynamic CT and MRI of a series of pathologically confirmed low-grade vascular neoplasia of the liver (LGVNL).

Materials and methods

In this retrospective multicenter study, patients diagnosed with pathologically proven LGVNL between January 2014 and August 2024 and with cross-sectional imaging (CT or MRI) were included. Based on prior studies, we divided the patients into two groups: a group with typical LGVNL features and a group with atypical tumors. Univariable analysis and the logistic regression model were used to evaluate the outcome of typical and atypical LGVNL features.

Results

Twenty-eight patients were included (20 men, mean age 53.7 ± 13.4 [SD] years old). The median size of tumors at diagnosis was 22 mm [IQR, 10–80]. A typical LGVNL pattern including thick continuous peripheral arterial phase “flower petal shape” enhancement was found on MRI in 67% (18/27) with lobulated lesions (p = 0.001), a marked hypersignal on T2-weighted images (p = 0.003) and a high apparent diffusion coefficient (ADC) (mean tumor ADC, 2.1 × 10−3 ± 0.3 [SD] mm2/s) (p = 0.006) with portal and delayed phase filling following contrast administration. An atypical LGVNL pattern was found in 33% (9/27), including homogeneous arterial phase enhancement that persisted during the portal and delayed phases. After a median follow-up of 16 months, tumor growth was observed in 42% (8/19) and was faster in patients with the atypical LGVNL pattern (p = 0.013).

Conclusion

The typical imaging pattern of LGVNL that includes arterial phase “flower petal shape” enhancement with a marked hypersignal on T2-weighted images and a high ADC was seen in most cases.

Key Points

Question Low-grade vascular neoplasia of the liver, including hepatic small vessel neoplasms and anastomosing hemangioma, is a new entity of vascular tumors with few radiological descriptions.

Findings Diagnostic imaging criteria include the “flower petal shape” enhancement pattern on arterial phase, a marked hypersignal on T2-weighted images and high ADC values.

Clinical relevance This multicenter study provides clinical, pathological and imaging data on low-grade vascular neoplasia of the liver and highlights specific imaging features for its diagnosis. Knowledge of these imaging features helps eliminate differential diagnoses.

Graphical Abstract