The imaging and pathologic characteristics of intracranial hemangioendothelioma

Abstract

Objective To investigate the neuroradiological features of MRI and CT of intracranial hemangioendothelioma (HE) and their relationship to histopathological characteristics. Methods We conducted a retrospective analysis of 7 patients with pathologically confirmed intracranial HE who were admitted to Department of Neurosurgery, Taizhou People's Hospital from January 2008 to June 2016. Their imaging features and pathological results were studied.All patients were performed MRI examinations.Among them 3 patients underwent CT scan and 1 patient underwent MRA examination. Results Among the 7 patients, 2 had lesions on the right side of the skull (1 on the frontal bone and 1 on the parietal bone), 2 in the tentorium, and 1 in the cerebral falx, 1 in the right cavernous sinus, and 1 in the right temporal lobe. The diameters of the lesions measured 2.1-5.3 cm with an average of (4.1±1.1) cm. Most appeared iso- or hypointense on T1-weighted MRI, with a multiple fleck pattern or small punctate hyper-intensities. Lesions appeared as inhomogeneous hyperintense regions on T2-weighted MRI, with multiple enlarged and tortuous blood flow voids. After contrast-enhanced scanning, lesions in all 7 cases had delayed enhancements, which showed a honeycomb-like marked enhancement. One case underwent MRA examination and the result showed abnormal increase of vascular imaging around the tumor. The CT scans showed a high-density region with many small round higher-density foci. Of the 7 cases, 4 were epithelial HE, 2 were retiform HE, and 1 was Kaposiform HE. Histological examination revealed endothelial cell proliferation, with vascular lesions and mucous matrix or dense fibrous mesenchyme. Conclusion MRI and CT Imaging findings of intracranial HE include certain characteristics, which might be closely related to its pathologic basis. Key words: Central nervous system neoplasms; Hemangioendothelioma; Tomography, X-ray computed; Magnetic resonance imaging; Pathology