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Imaging findings of intravascular papillary endothelial hyperplasia presenting in extremities: Correlation with pathological findings

Title
Imaging findings of intravascular papillary endothelial hyperplasia presenting in extremities: Correlation with pathological findings
Authors
Lee S.J.Choo H.J.Park J.S.Park Y.-M.Eun C.K.Hong S.H.Hwang J.Y.Lee I.S.Lee J.Jung S.-J.
Ewha Authors
황지영
SCOPUS Author ID
황지영scopus
Issue Date
2010
Journal Title
Skeletal Radiology
ISSN
0364-2348JCR Link
Citation
vol. 39, no. 8, pp. 783 - 789
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Objective: To describe magnetic resonance imaging (MRI) and ultrasound (US) findings of intravascular papillary endothelial hyperplasia (IPEH) arising in extremities. Materials and Methods: Six patients with IPEH confirmed by surgical resection were reviewed retrospectively. Before resection, 3 patients underwent both MRI and US and 3 patients underwent only MRI. Two radiologists retrospectively reviewed MR/US imaging results and correlated them with pathological features. Results: The 6 IPEHs were diagnosed as 4 mixed forms and 2 pure forms. The pre-existing pathology of four mixed forms was intramuscular or intermuscular hemangioma. By MRI, the mixed form of IPEH (n=4) revealed iso- to slightly high signal intensity containing nodule-like foci of high signal intensity on T1-weighted images (T1WI) and high signal intensity-containing nodule-like foci of low signal intensity on T2-weighted images (T2WI). The pure form of IPEH (n=2) showed homogeneous iso- signal intensity on T1WI and high and low signal intensity containing nodule-like foci of low signal intensity on T2WI. On gadolinium-enhanced fat-suppressed T1WI, 50% of cases (n=3: mixed forms) revealed peripheral, septal, and central enhancement. The other IPEHs (n=3: 1 mixed and 2 pure forms) showed peripheral and septal enhancement or only peripheral enhancement. By US, two mixed forms of IPEH showed well-defined hypoechoic masses containing hyperechoic septa and central portion with vascularities. One pure form of IPEH was a homogeneous hypoechoic mass with septal and peripheral vascularities on color Doppler imaging. The foci of high signal intensity on T1WI, foci of low signal intensity on T2WI, and non-enhancing portions on MRI and the hypoechoic portion on US were histopathologically correlated with thrombi and the peripheral/septal or central enhancing areas on MRI, hyperechoic septa and the central portion on US, and septal/central or peripheral vascularities on color Doppler imaging corresponded to hypertrophic papillary epithelium and a fibrovascular core. Conclusions: Even though imaging findings of the pure form of IPEH are rather nonspecific, the mixed form of IPEH should be considered a possible diagnosis when a well-defined mass with T2 hyperintense signal containing nodule-like foci of low signal intensity, T1 iso- to slightly hyperintense signal containing nodule-like foci of high signal intensity, and peripheral/septal or central enhancement on MRI is seen in extremities, along with the US finding of a hypoechoic mass containing hyperechoic septa with vascularities. © 2010 ISS.
DOI
10.1007/s00256-010-0888-2
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의학전문대학원 > 의학과 > Journal papers
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