Value of delayed post-contrast phase hyperintensity on gadobenate dimeglumine-enhanced MRI for differentiating atypical splenic hemangiomas from cysts: an exploratory retrospective study with pathology validation.
8 affiliations
- 1Department of Radiology, The First Affiliated Hospital, Fujian Medical University, 20. Cha-zhong Road, Fuzhou, Fujian, 350005, China.
- 2Department of Radiology, Binhai Campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fuzhou, 350212, China.
- 3Department of Nuclear Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
- 4Department of Nuclear Medicine, Binhai Campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fuzhou, 350212, China.
- 5Fujian Key Laboratory of Precision Medicine for Cancer, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
- 6Key Laboratory of Radiation Biology of Fujian Higher Education institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
- 7Department of Radiology, The First Affiliated Hospital, Fujian Medical University, 20. Cha-zhong Road, Fuzhou, Fujian, 350005, China. [email protected].
- 8Department of Radiology, Binhai Campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fuzhou, 350212, China. [email protected].
Abstract
Background
Incidental splenic cystic lesions are commonly encountered on MRI. Atypical hemangiomas with absent enhancement on conventional MRI (cMRI) may be misdiagnosed as simple cysts, yet they carry a small risk of spontaneous rupture. Delayed post‑contrast phase imaging using gadobenate dimeglumine (Gd-BOPTA) may detect contrast retention in hemangiomas, offering a potential discriminator. This study provides an exploratory evaluation of whether delayed post-contrast hyperintensity can help differentiate atypical splenic hemangiomas from true cysts.Methods
In this exploratory retrospective, single‑center study, we searched our PACS database for reports of splenic cysts or hemangiomas between June 2015 and June 2025. A consecutive series of 220 patients (162 lesions initially classified as cysts on cMRI, 58 as hemangiomas) was included. Two independent radiologists, blinded to clinical data and reference standard, assessed cMRI features and delayed post-contrast phase signal intensity. The index test was delayed post-contrast phase hyperintensity (yes/no). The reference standard was histopathology in an exploratory validation subset (n = 26); for the full cohort (n = 220), imaging findings were descriptively reported. Diagnostic accuracy metrics (sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV]) were explored in the pathologically confirmed subset with 95% confidence intervals using the Wilson score method.Results
Interobserver agreement was excellent for cMRI classification (κ = 0.86) and delayed post-contrast phase signal assessment (κ = 0.88). In the full cohort (n = 220), 82/162 (50.6%) of cMRI‑diagnosed cysts exhibited delayed post‑contrast hyperintensity, representing an imaging feature discordant with a simple cyst. Among the 26 pathologically confirmed lesions (validation subset), 18 were hemangiomas and 8 were cysts. Delayed post-contrast hyperintensity demonstrated, sensitivity 94.4% (95% CI: 72.7-99.9%), specificity 100% (95% CI: 67.6-100%), PPV 100% (95% CI: 81.6-100%), and NPV 88.9% (95% CI: 56.5-98.0%). The wide confidence intervals reflect the small sample size (n = 26) and inherent imprecision of these exploratory estimates.Conclusion
Delayed post-contrast hyperintensity on Gd-BOPTA-enhanced MRI is a potential imaging sign for differentiating atypical splenic hemangiomas from true cysts. This exploratory observation warrants prospective validation before clinical adoption.
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BibTeX
@article{li2026value,
title = {{Value of delayed post-contrast phase hyperintensity on gadobenate dimeglumine-enhanced MRI for differentiating atypical splenic hemangiomas from cysts: an exploratory retrospective study with pathology validation.}},
author = {Meina Li and Kaixian Lin and Feifei Yu and Yijing Zhao and Meilian Xiong and Dairong Cao and Zhen Xing},
journal = {BMC medical imaging},
year = {2026},
month = jul,
doi = {10.1186/s12880-026-02615-6},
url = {https://europepmc.org/article/MED/42928149},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Value of delayed post-contrast phase hyperintensity on gadobenate dimeglumine-enhanced MRI for differentiating atypical splenic hemangiomas from cysts: an exploratory retrospective study with pathology validation.
AU - Meina Li
AU - Kaixian Lin
AU - Feifei Yu
AU - Yijing Zhao
AU - Meilian Xiong
AU - Dairong Cao
AU - Zhen Xing
PY - 2026
DA - 2026/07/25
JO - BMC medical imaging
DO - 10.1186/s12880-026-02615-6
UR - https://europepmc.org/article/MED/42928149
AB - Background Incidental splenic cystic lesions are commonly encountered on MRI. Atypical hemangiomas with absent enhancement on conventional MRI (cMRI) may be misdiagnosed as simple cysts, yet they carry a small risk of spontaneous rupture. Delayed post‑contrast phase imaging using gadobenate dimeglumine (Gd-BOPTA) may detect contrast retention in hemangiomas, offering a potential discriminator. This study provides an exploratory evaluation of whether delayed post-contrast hyperintensity can help differentiate atypical splenic hemangiomas from true cysts.Methods In this exploratory retrospective, single‑center study, we searched our PACS database for reports of splenic cysts or hemangiomas between June 2015 and June 2025. A consecutive series of 220 patients (162 lesions initially classified as cysts on cMRI, 58 as hemangiomas) was included. Two independent radiologists, blinded to clinical data and reference standard, assessed cMRI features and delayed post-contrast phase signal intensity. The index test was delayed post-contrast phase hyperintensity (yes/no). The reference standard was histopathology in an exploratory validation subset (n = 26); for the full cohort (n = 220), imaging findings were descriptively reported. Diagnostic accuracy metrics (sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV]) were explored in the pathologically confirmed subset with 95% confidence intervals using the Wilson score method.Results Interobserver agreement was excellent for cMRI classification (κ = 0.86) and delayed post-contrast phase signal assessment (κ = 0.88). In the full cohort (n = 220), 82/162 (50.6%) of cMRI‑diagnosed cysts exhibited delayed post‑contrast hyperintensity, representing an imaging feature discordant with a simple cyst. Among the 26 pathologically confirmed lesions (validation subset), 18 were hemangiomas and 8 were cysts. Delayed post-contrast hyperintensity demonstrated, sensitivity 94.4% (95% CI: 72.7-99.9%), specificity 100% (95% CI: 67.6-100%), PPV 100% (95% CI: 81.6-100%), and NPV 88.9% (95% CI: 56.5-98.0%). The wide confidence intervals reflect the small sample size (n = 26) and inherent imprecision of these exploratory estimates.Conclusion Delayed post-contrast hyperintensity on Gd-BOPTA-enhanced MRI is a potential imaging sign for differentiating atypical splenic hemangiomas from true cysts. This exploratory observation warrants prospective validation before clinical adoption.
SN - 1471-2342
ER -