title: Hepatic hemangiomas: factors associated with T2 shine-through effect on diffusion-weighted MR sequences.
abstract: OBJECTIVE
  To determine the frequency and factors associated with the presence of T2 shine-through effect in hepatic hemangiomas on diffusion-weighted (DW) magnetic resonance (MR) sequences.
  
  
  METHODS
  This retrospective study was approved by institutional review board with waiver of informed consent. One hundred forty-nine consecutive patients with 388 hepatic hemangiomas who underwent a liver MR between January 2010 and November 2011 were included. MR analysis evaluated the lesion characteristics (signal intensities and enhancement patterns (classical, rapidly filling, delayed filling)), the presence of T2 shine-through effect on DW sequences (b values of 0, 150, and 600 s/mm2), and apparent diffusion coefficient (ADC) values. Multivariate analysis was performed to study the factors associated with the T2 shine-through effect.
  
  
  RESULTS
  T2 shine-through effect was observed in 204/388 (52.6%) of hepatic hemangiomas and in 100 (67.1%) patients. Mean ADC value of hemangiomas with T2 shine-through effect was significantly lower than hemangiomas without (2.0±0.48 vs 2.38±0.45, P<.0001). On multivariate analysis, high signal intensity on fat-suppressed T2-weighted fast spin-echo images, hemangiomas with classical or delayed enhancement, and the ADC of the liver were the only significant factors associated with T2 shine-through effect.
  
  
  CONCLUSIONS
  T2 shine-through effect is commonly observed in hepatic hemangiomas and is related to hemangiomas characteristics. Radiologists should be aware of this phenomenon which could lead to misdiagnosis. Its presence should not question the diagnosis of hemangiomas when typical MR findings are found.
authors.affiliation: Centre Hospitalier Universitaire Vaudois and University of Lausanne, Department of Radiology, Lausanne, Switzerland; Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy, France. Electronic address: Rafael.duran@chuv.ch.
authors.forename: Rafael
authors.initials: R
authors.lastname: Duran
authors.affiliation: Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy, France; University Paris Diderot, Sorbonne Paris Cité, INSERM U773, centre de recherche biomédicale Bichat-Beaujon, CRB3, Paris, France. Electronic address: Maxime.ronot@bjn.aphp.fr.
authors.forename: Maxime
authors.initials: M
authors.lastname: Ronot
authors.affiliation: Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy, France. Electronic address: Anne.kerbaol@bjn.aphp.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Kerbaol
authors.affiliation: Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy, France. Electronic address: Bernard.van-beers@bjn.aphp.fr.
authors.forename: Bernard
authors.initials: B
authors.lastname: Van Beers
authors.affiliation: Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy, France; University Paris Diderot, Sorbonne Paris Cité, INSERM U773, centre de recherche biomédicale Bichat-Beaujon, CRB3, Paris, France. Electronic address: Valerie.vilgrain@bjn.aphp.fr.
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003951:Diagnostic Errors / Q000517:prevention & control*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006391:Hemangioma / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Benign liver lesion; Diagnosis; Diffusion magnetic resonance imaging; Hemangioma; Imaging; MRI