Computed tomography and magnetic resonance features of intracranial hemangioendothelioma: A study of 7 cases.
The current study aimed to present the neuroradiological and histopathological features of intracranial hemangioendothelioma (HE). The computed tomography (CT; n=3) and magnetic resonance imaging (MRI; n=7) features, and the clinical presentations of 7 patients with pathologically documented HEs were retrospectively analyzed. Lesions were observed in the right side of the skull (the frontal bone in 1 patient and the parietal bone in 1 patient), the tentorium (2 patients), the cerebral falx (1 patient), the right cavernous sinus (1 patient) and the right temporal lobe (1 patient). The tumor was lobulated in 5 cases and round in 2 cases. The majority of tumors appeared isointense or hypointense with multiple scattered hyperintensities on T1-weighted MRI. Moreover, the lesions appeared as inhomogeneous hyperintense regions with multiple enlarged and tortuous blood flow voids on T2-weighted MRI. The lesions also showed marked gadolinium enhancement in a honeycomb pattern. CT scan results showed a isoattenuation region (32-47 HU), with numerous small, round, high-density foci. The 2 cases with skull lesions presented with local bone destruction and discontinuous bone lines of the tabula interna ossis cranii. In 1 case, MR angiography revealed abnormal vessels in the basilar region. A total of 4 cases were epithelial HE, 2 were retiform HE and 1 was kaposiform HE. Histological examination revealed endothelial cell proliferation with vascular lesions and a mucous matrix or dense fibrous mesenchyme. In conclusion, intracranial HE is rare, but should be considered in the differential diagnosis when evaluating intracranial neoplasms. A well-defined lobulated mass and imaging features that include internal heterogeneity, small scattered hemorrhages and thromboses, signal voids of vessels, and marked and delayed enhancement may confirm the diagnosis of HE.
Department of Radiology, Taizhou People's Hospital, Taizhou, Jiangsu 225300, P.R. China.
Wei-Zhong
WZ
Tian
Department of Radiology, Zhuhai People's Hospital, Jinan University, Zhuhai, Guangdong 519000, P.R. China.
Xiang-Rong
XR
Yu
Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.
Wei-Wei
WW
Wang
Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.
B O
BO
Zhang
Department of Radiology, Taizhou People's Hospital, Taizhou, Jiangsu 225300, P.R. China.
Jian-Guo
JG
Xia
Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China; Department of Radiology, Huashan Hospital Baoshan Branch, Fudan University, Shanghai 200431, P.R. China.
Han-Qiu
HQ
Liu
brain tumor; computed tomography; hemangioendothelioma; magnetic resonance imaging