Learning objectives
Hemangiomas are common focal liver lesions,
usually detected in the work up of asymptomatic patients.
In this poster we illustrate the spectrum of imaging findings of liver hemangioma emphasizing key diagnostic features in ultrasound (US),
computed tomography (CT) and magnetic resonance imaging (MRI) and theirs histopathological correlation.
We describe typical and atypical imaging features of hemangioma,
but also other liver abnormalities that associated with hemangiomas could mimic aggressive lesions.
And we refer some pitfalls in US,
CT and MR imaging as well as describe other...
Background
Liver hemangiomas have an estimated prevalence of 0.4 to 20%.
Being devoid of malignant potential,
they are usually discovered between that fourth and fifth decade of life during an abdominal imaging workup.1
Hemangiomas have been classified according to pathology into three varieties: capillary hemangioma,
cavernous hemangioma,
and mixed type hemangioma.2
Most liver hemangiomas in adults are cavernous hemangiomas3.
Their imaging features are well known,
as their pathological examination (Fig.1) that reveals a characteristic focal tender mass formed by multiple vascular channels limited by a single...
Findings and procedure details
1)Common imaging findings
1.1)Ultrasound:
The most common sonographic pattern of hemangiomas (Fig.
2) consists of homogeneous hyperechoic liver nodule,
with discrete posterior acoustic enhancement,
devoided of Doppler signal both on colour-coded and spectral examination.
Multiple interfaces between the walls of the sinuses and the blood within them account for the typical hyperechogenicity seen at US.
Because hemangiomas may undergo various changes such as internal hemorrhage with necrosis,
thrombosis,
myxomatous change,
fibrosis,
and rarely calcification as they become larger1,4,
atypical US features are frequently seen in...
Conclusion
Hemangiomas are a radiologist’s dream lesions because they often allow a confident diagnosis.
Dynamic imaging is immensely advantageous over single-phase imaging.
Knowledge of atypical features and pitfalls can limit diagnostic error.
However if diagnostic criteria are not reunited or doubtful,
a biopsy study should be recommended.
References
1. Vilgrain V,
Boulos L,
Vullierme MP,
Denys A,
Terris B,
Menu Y (2000).
Imaging of atypical hemangiomas of the liver with pathologic correlation.
Radiographics 20(2):379–397
2. Gentry RW,
Dokerty MB,
Clagett OT.
Vascular malformation and vascular tumors of the gastrointestinal tract.
In: International abstracts of surgery.
Chicago: The Franklin H.
Martin Memorial Fundation; 1949.
p.
281–323
3. Gibbs JF,
Litwin AM,
Kahlenberg MS (2004) Contemporary management of benign liver tumors.
Surg Clin North Am 84(2):463–480 Schneider G,
Grazioli L,
Saini S (2003)
4. Imaging...