Fig. 7
From: Imaging features of primary sites and metastatic patterns of angiosarcoma
30-year-old man with primary hepatic angiosarcoma and longstanding portal hypertension from microvascular veno-occlusive disease. a, b Axial contrast-enhanced CT images of the abdomen show a dominant mass in the posterior right hepatic lobe with smaller multifocal nodules. a Arterial phase CT image shows central foci of avid enhancement within the dominant lesion (arrows). b Portal venous phase CT shows progressive heterogeneous enhancement (arrows). There are features of portal hypertension with distension of the portal and hepatic veins (asterisks) and splenomegaly. c Axial T1-weighted in-phase image shows multifocal predominantly low signal intensity lesions compared to the adjacent liver parenchyma. There is a focus of high signal intensity within the large lesion posteriorly suggestive of haemorrhage (arrow). Small low T1 signal nodules within the enlarged spleen represent haemosiderin deposition related to portal hypertension (arrowheads). d Axial T2-weighted image shows multifocal heterogeneous hepatic lesions which are of predominantly high signal intensity. There is an incidental calculus within the gallbladder (arrowhead). e–g Axial T1-weighted dynamic contrast-enhanced MR images of the liver. Arterial (e), portal venous (f) and delayed-phase (g) images show peripheral nodular enhancement of the dominant lesion with progressive enhancement (arrow) and a persistent area of non-enhancement (asterisk). Smaller nodules elsewhere in the liver also show progressive enhancement but appear relatively homogeneous compared to the dominant lesion (arrowheads)