Article Dans Une Revue European Radiology Année : 2025

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

Maïté Lewin
Rauda Aldhaheri
  • Fonction : Auteur
Aurélie Beaufrère
  • Fonction : Auteur
Ivan Bricault
  • Fonction : Auteur
Paul Borde
  • Fonction : Auteur
Gabriel Simon
  • Fonction : Auteur
Mickaël Lesurtel
  • Fonction : Auteur
Daniel Cherqui
  • Fonction : Auteur
Clara Prud’homme
  • Fonction : Auteur
Valérie Vilgrain
  • Fonction : Auteur
Astrid Laurent-Bellue
  • Fonction : Auteur

Résumé

Abstract 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] mm 2 /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

Dates et versions

hal-05542617 , version 1 (09-03-2026)

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Citer

Maïté Lewin, Rauda Aldhaheri, Aurélie Beaufrère, Christophe Desterke, Anita Paisant, et al.. Imaging features of recently identified low-grade vascular neoplasia of the liver: hepatic small vessel neoplasm and anastomosing hemangioma. European Radiology, 2025, 36 (3), pp.1887-1898. ⟨10.1007/s00330-025-11915-4⟩. ⟨hal-05542617⟩
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