Liver Hemangioma : Imaging
Comments:
Imaging: Liver hemangiomas (LH) have to be distinguished from other benign and malignant tumors of the liver, including hepatic adenomas, hepatocellular carcinomas, and liver metastases. A variety of imaging modalities are available such as ultrasound, contrast-enhanced CT, MRI, PET/CT, and angiography. Usually, the diagnosis can be confidently made with one of these techniques. Biopsy is done as a last resort due to the risk of bleeding from these highly vascular tumors. On ultrasound, LHs appear homogenously hyperechoic with distinct margins. On pre-contrast CT (shown here), they appear as well-defined hypodense lesions (darker than surrounding liver parenchyma). With contrast-enhanced CT, there is early peripheral nodular enhancement in the arterial phase and slow, progressive centripetal filling in the portal venous phase. With MRI, they show high signal intensity on T2 weighted images. MRI has a sensitivity of 98% and specificity of 99% for diagnosing LHs. Case courtesy of Dr Natalie Yang, Radiopaedia.org. From the case rID: 7014