Clinical and imaging features of Kaposiform hemangioendothelioma in infants
Yuanjun Hu,
Dan Song,
Changhua Wu,
Liang Wang,
Jing Li,
Lei Guo
Affiliations
Yuanjun Hu
Department of Pediatric Surgery, Children's Hospital Affiliated to Shandong, University, Jinan, 250022, Shandong, China; Department of Pediatric Surgery, Jinan Children's Hospital, Jinan, 250022, Shandong, China
Dan Song
Department of Vascular Anomalies and Interventional Radiology, Children's, Hospital Affiliated to Shandong University, Jinan, 250022, Shandong, China; Department of Vascular Anomalies and Interventional Radiology, Jinan Children's, Hospital, Jinan, 250022, Shandong, China; Department of Shandong Provincial Clinical Research Center for Children's Health and Disease, Jinan, 250022, Shandong, China
Changhua Wu
Department of Vascular Anomalies and Interventional Radiology, Children's, Hospital Affiliated to Shandong University, Jinan, 250022, Shandong, China; Department of Vascular Anomalies and Interventional Radiology, Jinan Children's, Hospital, Jinan, 250022, Shandong, China; Department of Shandong Provincial Clinical Research Center for Children's Health and Disease, Jinan, 250022, Shandong, China
Liang Wang
Department of Vascular Anomalies and Interventional Radiology, Children's, Hospital Affiliated to Shandong University, Jinan, 250022, Shandong, China; Department of Vascular Anomalies and Interventional Radiology, Jinan Children's, Hospital, Jinan, 250022, Shandong, China; Department of Shandong Provincial Clinical Research Center for Children's Health and Disease, Jinan, 250022, Shandong, China
Jing Li
Department of Vascular Anomalies and Interventional Radiology, Children's, Hospital Affiliated to Shandong University, Jinan, 250022, Shandong, China; Department of Vascular Anomalies and Interventional Radiology, Jinan Children's, Hospital, Jinan, 250022, Shandong, China; Department of Shandong Provincial Clinical Research Center for Children's Health and Disease, Jinan, 250022, Shandong, China
Lei Guo
Department of Vascular Anomalies and Interventional Radiology, Children's, Hospital Affiliated to Shandong University, Jinan, 250022, Shandong, China; Department of Vascular Anomalies and Interventional Radiology, Jinan Children's, Hospital, Jinan, 250022, Shandong, China; Department of Shandong Provincial Clinical Research Center for Children's Health and Disease, Jinan, 250022, Shandong, China; Corresponding author. Department of Vascular Anomalies and Interventional Radiology, Children's, Hospital Affiliated to Shandong University, Jinan, 250022, Shandong, China.
Objective: Kaposiform hemangioendothelioma (KHE) is a locally aggressive tumor of vascular origin. This study investigated the clinical and imaging features of KHE to provide a reference for its early diagnosis. Methods: The clinical and imaging findings of 27 clinically confirmed KHE cases (including 21 with focal lesions and 6 with diffuse lesions) between January 2016 and December 2021 were retrospectively analyzed. Results: The mean age of the 27 patients was 105 ± 80.27 days. Twenty-two (81.5%) of these patients had Kasabach–Merritt phenomenon. Most KHEs were located in the trunk and/or extremities (22/27). Ultrasonography showed heterogeneous echogenicity and/or striated hypoechoic bands with abundant or patchy blood flow within the tumor. On plain computed tomography (CT), they appeared as heterogeneous lesions isodense with the muscles, with a CT value of 29.58 ± 11.53 HU. In the arterial phase, the KHEs showed striated or lamellar heterogeneous enhancement, with a CT value of 153.91 ± 52.11 HU after enhancement. All KHEs showed uneven and high signal intensity on T2-weighted imaging, mixed high and low signal intensity on fat-saturated images, and no significant diffusion restriction on diffusion-weighted imaging. Conclusion: KHEs can occur in various locations and present as highly infiltrative and heterogeneous masses that can invade the skin, adjacent muscles, and bones. A vascularized mass with purpuric skin changes, with uneven and high T2WI signal is highly suggestive of the diagnosis of KHE.
