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.
Keywords: Splenic cyst, Atypical splenic hemangioma, Gadobenate dimeglumine, Exploratory diagnostic accuracy
Background
Splenic lesions are often asymptomatic and detected incidentally. While uncommon, accurate characterization is crucial as management decisions often rely heavily on imaging [1, 2]. Cysts and hemangiomas are among the most frequent incidental splenic lesions [3]. Both are typically benign but differ in clinical implications; splenic hemangiomas, although rare, carry a potential risk of spontaneous rupture leading to life-threatening hemorrhage [4, 5], making accurate differentiation important for patient counseling and follow-up planning.
Typical hemangiomas are usually diagnosed based on characteristic conventional MRI (cMRI) features [6]. However, atypical variants (e.g., with cystic degeneration or extensive hemorrhage) can mimic cysts on cMRI [7], presenting a diagnostic dilemma. In clinical practice, lesions appearing as non-enhancing T2-hyperintense cysts on cMRI are often diagnosed as such. This study arose from the clinical observation that a subset of these “cysts” exhibited hyperintensity on the delayed post-contrast phase when gadobenate dimeglumine (Gd-BOPTA) was used for concurrent liver evaluation.
Gd-BOPTA is a dual-purpose contrast agent that enables both dynamic vascular-phase imaging and, because of its hepatobiliary properties, late-phase imaging at 90–120 min post-injection. In the context of splenic lesions, we refer to this acquisition as the “delayed post-contrast phase” to avoid implying hepatocyte-specific uptake, since the spleen lacks functional hepatocytes. Pathologically, splenic cysts are devoid of vascular structures; consequently, contrast material cannot enter the lesion, and they are expected to appear hypointense on delayed post-contrast images. By contrast, splenic hemangiomas consist of blood-filled vascular spaces of varying wall thickness. The contrast agent enters these spaces and washes out slowly [8–10], which may result in delayed retention on the delayed post-contrast phase, manifesting as hyperintensity. This interpretation is supported by prior work demonstrating that late-phase hyperintensity with hepatobiliary contrast agents reflects contrast retention within vascular/interstitial spaces rather than hepatocyte-specific uptake [11–13]. While the hepatobiliary phase is established for liver lesion characterization [14, 15], its value for splenic lesions is underexplored. Therefore, this exploratory study aimed to: (1) describe the frequency of delayed post-contrast hyperintensity among splenic lesions diagnosed as cysts on cMRI, and (2) provide an exploratory assessment of whether this sign can help differentiate atypical hemangiomas from cysts using a pathologically validated subset. We hypothesize that delayed post-contrast hyperintensity may serve as a useful adjunct sign to identify atypical hemangiomas masquerading as cysts on cMRI.
Methods
Patients
This retrospective study was approved by the Institutional Review Board of the First Affiliated Hospital of Fujian Medical University, and the requirement for informed consent was waived. The off-label use of Gd-BOPTA for splenic lesion assessment was acknowledged and approved under this protocol, as all patients received the agent for standard abdominal imaging indications.
Consecutive patients were identified by searching our PACS database for reports containing “splenic cyst” or “splenic hemangioma” between June 2015 and June 2025. This search strategy may introduce ascertainment bias, as lesions reported under other terms (e.g., ‘splenic mass’, ‘indeterminate nodule’) were not captured. Exclusion criteria were: (1) Incomplete MRI; (2) Poor image quality; (3) Lesions with intrinsic T1 hyperintensity (suggesting hemorrhage/protein). No sample size calculation was performed; the study cohort represents a convenience sample of all eligible patients during the study period. The patient selection process is illustrated in Fig. 1.
Fig. 1.
Study flow diagram of patient inclusion and exclusion
Reference standard and study design clarification
This study had a hierarchical design
Primary Descriptive Analysis: We first described the imaging findings across the entire cohort (n = 220), focusing on the subgroup initially classified as cysts on cMRI (n = 162). The key observation was the proportion of these lesions demonstrating delayed post-contrast hyperintensity.
Exploratory Validation Analysis: For the subset of lesions with available pathological confirmation (n = 26; surgical indications detailed in Results), we used pathology as the reference standard to exploratorily evaluate the diagnostic accuracy of delayed post-contrast hyperintensity. This analysis was defined post hoc as exploratory/hypothesis-generating.
Handling of indeterminate index test results: Delayed post-contrast phase isointensity (n = 3 in the cMRI-diagnosed cyst group; n = 4 in the cMRI-diagnosed hemangioma group) was a priori categorised as non-hyperintense for all diagnostic accuracy calculations, as it does not meet the definition of hyperintensity and would not contribute to a positive index test result.
MRI protocol
All examinations were performed on Siemens 3.0T scanners (Skyra, Prisma, Verio) with a phased-array torso coil. Sequences included: Coronal HASTE T2WI; Axial fat-suppressed T2WI; Axial in-/opposed-phase T1WI; Axial DWI (b = 50, 800 s/mm²); ADC maps. Dynamic contrast-enhanced imaging: A bolus of Gd-BOPTA (MultiHance; 0.2 mmol/kg) was injected at 2–3 mL/s, followed by a 15 mL saline flush. Axial T1-weighted 3D GRE (VIBE) sequences were acquired pre-contrast and during the arterial (20–25 s), portal venous (60–70 s), delayed (2-minute), and a delayed post-contrast phase. The delayed post-contrast phase was uniformly acquired at 90–120 min post-injection across the entire study period (2015–2025). The core VIBE sequence parameters were identical by protocol across all three platforms.
Image analysis
Two-phase blinded review: Two radiologists (R1, R2; 5 and 7 years of abdominal radiology experience) independently reviewed all images in random order, blinded to clinical data, original reports, and the final reference standard. All readings were performed in two separate sessions, at least 4 weeks apart, to reduce the likelihood of recall bias, although residual memory effects cannot be completely excluded.
Phase 1 (cMRI assessment): Reviewers evaluated lesions on pre-contrast and dynamic phases (up to 2-min delay) using predefined criteria:
Cyst: T1WI hypointensity, T2WI marked hyperintensity, no diffusion restriction (high apparent diffusion coefficient (ADC)), no enhancement on any dynamic phase [6].
Hemangioma: T1WI hypointensity, T2WI marked hyperintensity. Enhancement: peripheral nodular/rim enhancement on arterial phase with progressive centripetal fill-in on portal venous and delayed phases or homogeneous intense enhancement on arterial phase persisting on later phases [16, 17].
Atypical hemangioma: T1WI hypointensity, T2WI marked hyperintensity, no diffusion restriction. Enhancement: Cystic morphology with no visible enhancement on any dynamic phase, or only mild septal/marginal enhancement [7].
Phase 2 (Delayed post-contrast phase assessment): In a separate session, the same reviewers evaluated the delayed post-contrast phase signal intensity (hyperintense [signal > splenic parenchyma], isointense [signal = splenic parenchyma], or hypointense [signal < splenic parenchyma]) for all lesions. Reviewers remained blinded to the cMRI-based classification and to the composite diagnosis.
Discrepancies in either phase were resolved by a senior radiologist (> 20 years of experience) to establish a consensus reading.
Unit of analysis: Only one lesion per patient was included for analysis. In patients with multiple lesions, the largest lesion was selected as the representative lesion; all imaging features, including delayed post-contrast phase signal, were consistent among lesions within the same patient.
Statistical analysis
Statistical analyses were performed using SPSS (version 23.0, IBM Corp). Categorical data are presented as n (%), continuous data as mean ± SD (normal distribution) or median (IQR) (non‑normal). Interobserver agreement was assessed with Cohen’s kappa (κ), interpreted as: 0.81–1.00 very good, 0.61–0.80 good, 0.41–0.60 moderate, 0.21–0.40 fair, < 0.20 poor. Diagnostic accuracy measures (sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV]) were calculated strictly within the pathologically confirmed subset (n = 26) using standard formulae. 95% confidence intervals for sensitivity, specificity, positive predictive value, and negative predictive value were calculated using the Wilson score method. Group comparisons used chi-square or Fisher’s exact tests. P < 0.05 was considered statistically significant.
Results
Baseline characteristics and cMRI findings
A total of 220 patients (162 cMRI-diagnosed cysts, 58 cMRI-diagnosed hemangiomas) were included. Baseline demographics and lesion characteristics are summarized in Table 1. No significant differences in age, sex, or lesion size were found between the cMRI-based cyst and hemangioma groups (all P > 0.05). All lesions showed T1 hypointensity and T2 hyperintensity without diffusion restriction. Enhancement patterns for hemangiomas are detailed in Table 1. Interobserver agreement was excellent for both cMRI classification (κ = 0.86; 95% CI: 0.79–0.93) and delayed post-contrast phase (κ = 0.88; 95% CI: 0.82–0.94).
Table 1.
Characteristics of enrolled patients (Full Cohort, n = 220)
| Parameter | Cysts (n = 162) | Hemangiomas (n = 58) | P value |
|---|---|---|---|
| Sex (Male/Female) | 91/71 (56.2%/43.8%) | 26/32 (44.8%/55.2%) | 0.215 |
| Age (years) | 58.25 ± 12.95 | 57.72 ± 11.96 | 0.782 |
| Lesion Size (cm) | 1.04 ± 1.05 | 1.16 ± 0.70 | 0.355 |
| Solitary/Multiple | 149/13 (92.0%/8.0%) | 51/7 (87.9%/12.1%) | 0.354 |
| Margin | well-defined | well-defined | - |
| Morphology | round/oval | round/oval/lobulated | - |
| T1WI Signal | hypointense | hypointense | - |
| T2WI Signal | markedly hyperintense | markedly hyperintense | - |
| DWI Signal | iso-/hypointense | iso-/hypointense | - |
| ADC Signal | hyperintense | hyperintense | - |
|
Enhancement pattern, n (%) |
no enhancement (100%) | mild arterial + persistent delayed enhancement:44 (75.9%); homogeneous arterial enhancement:8 (13.8%); Septal enhancement + fill-in:4 (6.9%); minimal peripheral enhancement:2 (3.4%) | -† |
| Delayed post-contrast phase Signal n (%) | hyperintense: 82 (50.6%); isointense: 3 (1.9%); hypointense: 77 (47.5%) | hyperintense: 54 (93.1%); isointense: 4 (6.9%); hypointense: 0 (0%) | < 0.001 |
† P‑values are reported only for non‑tautological comparisons. Variables used for group definition (T1, T2, DWI/ADC, enhancement pattern) are presented descriptively
Descriptive findings (Full Cohort, n = 220)
The distribution of delayed post-contrast phase signal intensity is presented in Table 1. In the full cohort, in the cMRI-diagnosed cyst group (n = 162), delayed post-contrast phase signal was hyperintense in 82 lesions (50.6%), an imaging feature discordant with a simple cyst, although pathological confirmation is lacking. isointense in 3 (1.9%), and hypointense in 77 (47.5%). In the cMRI-diagnosed hemangioma group (n = 58), delayed post-contrast phase signal was hyperintense in 54 lesions (93.1%) and isointense in 4 (6.9%). The difference in delayed post-contrast phase signal distribution between groups was significant (P < 0.001).
Of the 162 patients with cMRI-diagnosed cysts who did not undergo surgery, 146 (90%) had at least one follow-up MRI (median interval: 12 months). Among the 82 lesions that showed delayed post-contrast hyperintensity, 78 had follow-up imaging available; all 78 remained stable in size and morphology, and no lesion developed enhancing components, internal septations, or other features concerning for an alternative diagnosis. No spontaneous rupture was recorded. The remaining 4 patients were lost to follow-up.
Exploratory diagnostic accuracy in the pathologically confirmed subset (n = 26)
In the pathologically confirmed subset (n = 26 lesions, 18 hemangiomas and 8 cysts), surgery was performed for the following indications: splenomegaly work-up (n = 8), suspected malignancy (n = 2), symptomatic lesions (n = 3), contiguous pancreatic disease requiring splenectomy with incidental splenic lesion resection (n = 6), patient insistence despite absence of a definitive surgical indication (n = 6), and splenic trauma (n = 1). Histopathology was available for all 26 lesions. Table 2 presents the 2 × 2 cross-tabulation of delayed post-contrast hyperintensity against the reference standard. All 8 pathologically confirmed cysts exhibited delayed post-contrast hypointensity. Of the 18 pathologically confirmed hemangiomas, 17 (94.4%) showed delayed post-contrast hyperintensity (15 uniform, 2 heterogeneous), and 1 was isointense. Within this small validation subset only, delayed post-contrast hyperintensity for differentiating hemangioma from cyst showed a sensitivity of 94.4% (17/18; 95% CI: 72.7–99.9%), specificity of 100% (8/8; 95% CI: 67.6–100%), PPV of 100% (17/17; 95% CI: 81.6–100%), and NPV of 88.9% (8/9; 95% CI: 56.5–98.0%). The wide confidence intervals reflect the small sample size (n = 26) and inherent imprecision of these exploratory estimates.
Table 2.
Cross-tabulation of delayed post-contrast hyperintensity versus histopathology in the validation cohort (n = 26)
| Delayed post-contrast phase signal | Histopathology: Hemangioma (n = 18) | Histopathology: Cyst (n = 8) | Total |
|---|---|---|---|
| Hyperintense | 17 (TP) | 0 (FP) | 17 |
| Not hyperintense* | 1 (FN) | 8 (TN) | 9 |
| Total | 18 | 8 | 26 |
*: “Not hyperintense” includes isointense (n = 1 in the hemangioma group) and hypointense (n = 8 in the cyst group) lesions. Isointense lesions were prespecified as “non‑hyperintense” as they do not meet the definition of a positive index test
Abbreviations: TP, true positive; FP, false positive; FN, false negative; TN, true negative
The 26 operated lesions were compared with the remaining 194 non-operated lesions. No statistically significant differences were found in lesion size (mean 1.35 cm vs. 1.05 cm, P = 0.056), morphology, T1/T2 signal characteristics, or delayed post‑contrast phase signal intensity (all P > 0.05). Representative cases are illustrated in Figs. 2, 3, 4 and 5.
Fig. 2.
A patient with splenic lesion found during evaluation for biliary dilatation. The splenic lesion demonstrated features consistent with a cyst on conventional MRI (hypointensity on T1WI (a), obvious hyperintensity on T2WI (b) and ADC (d), isointensity on DWI (c), and no enhancement on the contrast-enhanced T1WI (e-g)). Hypointensity on the delayed post-contrast phase (h) was concordant with a cystic diagnosis, suggesting this lesion is a splenic cyst
Fig. 3.
A patient with splenic lesion found during pelvic mass evaluation. The splenic lesion demonstrated features consistent with a cyst on conventional MRI (hypointensity on T1WI (a) and DWI (c), obvious hyperintensity on T2WI (b) and ADC (d), and no enhancement on the contrast-enhanced T1WI (e-g)). However, hyperintensity on delayed post-contrast phase (h) was discordant with a cystic lesion. This constellation of findings (cystic appearance on conventional MRI with delayed post-contrast phase hyperintensity) raises suspicion for an atypical hemangioma, indicating that lesions fulfilling these imaging criteria may be misclassified as simple cysts on conventional MRI alone
Fig. 4.
A patient with splenic lesion found on screening. The splenic lesion exhibited features consistent with a cyst on conventional MRI (isointensity on T1WI (a), obvious hyperintensity on T2WI (b) and ADC (c), and no enhancement on the contrast-enhanced T1WI (d-f)), and the hypointensity on delayed post-contrast phase (g) was consistent with the appearance of a cyst. The diagnosis of splenic cyst was pathologically (h) confirmed
Fig. 5.
A patient with splenic mass found on screening. A splenic cystic lesion was initially diagnosed as a cyst on conventional MRI (hypointensity on T1WI (a), markedly hyperintensity on T2WI (b) and ADC (c), and minimal persistent peripheral enhancement was noted on review contrast-enhanced T1WI (d-f). Heterogeneous hyperintensity on delayed post-contrast phase (g) was inconsistent with a cyst but compatible with a hemangioma. Pathology (h) confirmed cavernous hemangioma with hemorrhage
Discussion
This exploratory study provides preliminary evidence that delayed post-contrast hyperintensity on Gd-BOPTA-enhanced MRI is associated with splenic hemangiomas in our limited surgical subset, including those with an atypical, cyst-mimicking appearance on cMRI. In the pathologically validated subset, the sign demonstrated high sensitivity (94.4%) and specificity (100%), but these estimates are based on only 26 lesions with wide confidence intervals (sensitivity 72.7–99.9%, specificity 67.6–100%), underscoring substantial imprecision and the likelihood of overestimation due to verification bias. Notably, half (50.6%) of the lesions meeting cMRI criteria for a simple cyst exhibited delayed post-contrast hyperintensity, which is an imaging observation, not a histologically proven reclassification rate. This finding suggests that a substantial proportion of such lesions may represent atypical hemangiomas, a hypothesis that requires prospective confirmation.
The differential delayed post-contrast phase signal is rooted in pathology. Splenic cysts are avascular and cannot retain contrast (hypointense) [18–20], while hemangiomas (even atypical variants) have vascular spaces enabling prolonged contrast retention (hyperintense) [21, 22]. As supported by prior studies on hepatobiliary contrast agents [11–13], this hyperintensity on the delayed post-contrast phase is attributable to contrast retention within vascular/interstitial spaces of hemangiomas, not to hepatocyte-specific uptake—a distinction relevant when applying contrast-enhanced MRI terminology to extrahepatic lesions. Unlike their hepatic counterparts, splenic hemangiomas often show milder, more progressive enhancement rather than a classic peripheral nodular pattern. This likely reflects differences in background organ hemodynamics and their histologic makeup of slow-flow vascular sinusoids [23–26]. This allows for gradual contrast agent entry and, crucially, very slow washout, leading to persistent retention and pronounced hyperintensity on the delayed post-contrast phase. This functional information complements the morphologic assessment of cMRI. While hepatobiliary phase imaging is well established for liver lesions [14, 15], its application to the spleen has been scarcely reported. Our findings extend the utility of this technique to a common diagnostic dilemma in abdominal radiology.
It is important to note that alternative diagnoses for such delayed hyperintensity exist. Splenic lymphangioma, another benign cystic lesion, may also exhibit hyperintensity on the delayed post-contrast phase. However, based on our case review, this hyperintensity is typically confined to the septa and cyst wall, with the cystic fluid remaining hypointense, a pattern distinct from the more uniform hyperintensity we observed in suspected atypical hemangiomas. This distinction, while preliminary, provides a potential imaging discriminator between these two entities. The delayed post-contrast signal characteristics of other extremely rare splenic cyst-like lesions (e.g., cystic metastases, abscesses) remain unreported, and our sign should therefore be regarded as an imaging observation rather than definitive histology.
This study addresses a practical dilemma. Differentiating an atypical, non-enhancing hemangioma from a cyst has management implications. While both are typically benign, hemangiomas have a documented, albeit rare, risk of complications including rupture [4, 5]. Correct identification allows for informed patient counseling and prudent follow-up. Based on our exploratory findings, we suggest the following hypothesis-generating approach: For an incidentally detected splenic lesion that appears as a simple cyst on cMRI (no enhancement), the presence of delayed post-contrast hyperintensity may prompt consideration of atypical hemangioma in the differential diagnosis. This approach is most relevant for patients who are already undergoing Gd-BOPTA-enhanced MRI for other indications (e.g., liver characterization), thereby adding diagnostic value without additional scan time or contrast dose. Among the 82 non-operated lesions with delayed post-contrast hyperintensity, 78 had follow-up imaging available; all 78 remained stable on follow-up (median 12 months), which is reassuring but does not constitute histological proof, as indolent benign entities may remain unchanged over the observed interval. The remaining 4 patients were lost to follow-up.
The spleen is frequently referred to as the ‘forgotten organ’, with a paucity of relevant research. Previous studies on the imaging differentiation of splenic lesions have predominantly focused on analyzing enhancement patterns in contrast-enhanced CT and MRI [27]. This study contributes to the sparse literature on delayed post-contrast imaging of the spleen. From a methodological standpoint, our qualitative approach proved robust: signal intensity was assessed qualitatively, and the high interobserver agreement (κ = 0.88) supports the reproducibility of this approach. We emphasise that this sign is not intended to replace cMRI, nor to advocate routine use of Gd-BOPTA solely for spleen assessment. Rather, it represents an opportunistic, value-added observation when delayed post-contrast phase images are already available. Future studies incorporating quantitative lesion-to-spleen signal ratios in larger pathologically confirmed cohorts may help refine diagnostic thresholds.
Several important limitations of our study must be acknowledged. First, limited reference standard and imprecision. The pathologically confirmed subset is small (n = 26, including only 8 cysts). Sensitivity and specificity are based on this subset and carry wide confidence intervals (e.g., sensitivity 72.7–99.9%, specificity 67.6–100%), reflecting substantial imprecision. These estimates may be overestimated and should be interpreted as exploratory. Second, selection and verification bias. The pathology subset was derived from patients undergoing surgery for heterogeneous indications and is inherently selected. Although we found no statistically significant differences in lesion size or imaging features between operated and non‑operated lesions, the modest sample size (n = 26) limits the power to detect subtle differences. Consequently, the reported metrics may not generalize to all incidental splenic lesions, and prospective validation in an unselected cohort is required. Third, our PACS search strategy may have missed splenic lesions reported under alternative terms; the imaging characteristics of such lesions remain unknown. Consequently, our findings may not be directly extrapolated to all incidental splenic cystic lesions. Fourth, our cohort was limited to cysts and hemangiomas. Other cystic entities such as lymphangioma may also exhibit delayed hyperintensity, though possibly with a septal-predominant rather than solid pattern. Their full imaging spectrum remains poorly characterized. Prospective studies with broader histopathological diversity are needed to validate and refine this distinction.
Conclusion
In this exploratory study, delayed post-contrast hyperintensity on Gd-BOPTA-enhanced MRI demonstrated a promising association with splenic hemangiomas in our small, pathologically confirmed subset, with high interobserver agreement (κ = 0.88). In the full cohort, half of cMRI-diagnosed cysts exhibited this discordant finding, suggesting that atypical hemangiomas may be underrecognized on conventional MRI. However, given the small validation sample and wide confidence intervals, these findings remain hypothesis-generating and require prospective validation before clinical adoption.
Acknowledgements
Not applicable.
Abbreviations
- cMRI
Conventional magnetic resonance imaging
- Delayed post-contrast phase
Acquisition at 90–120 min post-injection (corresponding temporally to the hepatobiliary phase in liver imaging; this terminology is used for splenic lesions to avoid implying hepatocyte-specific uptake)
- T1WI
T1-weighted imaging
- T2WI
T2-weighted imaging
- DWI
Diffusion-weighted imaging
- ADC
Apparent diffusion coefficient
- GRE
Gradient-recalled echo
- VIBE
Volumetric interpolated breath-hold examination
- FOV
Field of view
Author contributions
Meina Li: Writing - original draft, Formal analysis, Data curation, Conceptualization. Kaixian Lin: Investigation, Formal analysis.Feifei Yu: Investigation, Data curation, Methodology. Yijing Zhao: Investigation, Validation, Data curation. Meilian Xiong: Investigation, Data curation, Funding acquisition. Dairong Cao: Investigation, Supervision. Zhen Xing: Writing - review & editing, Resources, Formal analysis, Conceptualization.
Funding
This work was supported by the Startup Research Fund for Scientific Research of Fujian Medical University (Grant No.: 2019QH1097).
Data availability
Due to patient privacy and ethical restrictions, the imaging and clinical data are not publicly shared. De-identified data may be provided by the corresponding author upon reasonable request and with appropriate institutional approvals.
Declarations
Ethics approval and consent to participate
The study was approved by the Institutional Review Board of the First Affiliated Hospital of Fujian Medical University. Individual informed consent was waived due to the retrospective study design. All procedures performed in this study involving human participants were in accordance with the Declaration of Helsinki.
Consent for publication
Not applicable.
Competing interest
The authors declare no competing interests.
Footnotes
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
Due to patient privacy and ethical restrictions, the imaging and clinical data are not publicly shared. De-identified data may be provided by the corresponding author upon reasonable request and with appropriate institutional approvals.