Hepatic epithelioid hemangioendothelioma: analysis of the correlation of imaging characteristics with histopathological findings
To analyze the imaging characteristics of hepatic epithelioid hemangioendothelioma (EHE) and their correlation with histopathological findings. CT and MRI imaging and histopathological characteristics of five patients with hepatic EHE were retrospectively reviewed and the correlation of their imaging characteristics with pathological findings was analyzed. A total of 92 lesions were found in the 5 patients, all presenting with multiple nodules. All the 92 lesions were located within a 2-cm zone heneath the hepatic capsule, i.e., the shortest distance from the horder of lesions to the hepatic capsule. 28 of the 92 lesions showed the "capsular retraction" sign. 36 lesions were found in three patients receiving MRI. 77.8% of the 36 lesions demonstrated the "halo" sign on a fat-suppression T2- weighted image, while 91.7% after contrast enhancement. A peripheral dark rim was found in 91.7% of the lesions on a fat-suppression T2-weighted image. In addition, 36.1% of the lesions showed slight internal or edge enhancement at the hepatohiliary phase. In the two patients receiving CT examination, 7 of 56 lesions demonstrated the "halo" sign. Hepatic EHE may manifest as nodular lesions with predilection of peripheral subcapsular growth and nodular confluence, together with "halo" sign and " capsular retraction". The peripheral dark rim on a fat-suppression T2-weighted image and slight enhancement at the hepatobiliary phase can help to improve the accuracy of diagnosis and differential diagnosis of this hepatic tumor. MRI is superior to CT imaging to denict their intra-lesional characteristics.