Hepatic metastases of soft tissue angiosarcoma: CT and MR imaging findings.

Abstract

We describe the computed tomographic (CT) and magnetic resonance imaging (MRI) findings of hepatic metastases caused by soft tissue angiosarcomas to clarify the relation between radiologic appearances and clinicopathologic features. CT and MR examinations of 13 patients with hepatic metastases of soft tissue angiosarcoma were retrospectively analyzed. Contrast-enhanced CT images showed multiple hypoattenuating lesions relative to the adjacent liver parenchyma. Lesions contained peripheral areas of enhancement in eight patients (62%). Tumors showed cystic attenuation with fluid-fluid levels, which were suggestive of hemorrhage in five patients (38%). In one patient (8%) with cystic attenuation and fluid-fluid levels, lesions also contained marked enhanced nodular portions located centrally or peripherally. On T1-weighted MR images, all four liver tumors appeared heterogeneous and hypointense relative to adjacent liver parenchyma. Fluid-fluid levels were identified on T2-weighted MR images in five patients (38%). After an intravenous bolus of gadolinium-based contrast material was administered, slight peripheral enhancement was seen in three patients (75%). The common CT findings of metastatic angiosarcoma in our series were multiple hypoattenuating lesions often associated with nodular enhancement and cystic lesions with hemorrhagic change.