This is the most common benign liver tumour and affects 2%-5% of the population . It is more common in women and is composed of blood-filled...
This is the most common benign liver tumour and affects 2%-5% of the population. It is more common in women and is composed of blood-filled spaces contained by fibrous walls lined by epithelial cells. They
are often asymptomatic, but may present with hepatomegaly or, rarely, spontaneous haemorrhage. There are two types:
• Simple (most common, multiple in 10%, may enlarge during pregnancy)
• Cavernous/giant (rare, >5 cm, may cause symptoms due to haemorrhage or necrosis)
US
• Hyperechoic, well defined and lobulated
• Large haemangioma may appear heterogeneous
• Can be hypoechoic, especially in paediatric patients = cavernous haemangioma
• No flow within, may have adjacent flow (cavernous haemangioma may show internal flow)
CT
• Well-defined, hypodense mass pre-contrast
• Early peripheral nodular enhancement with central fill in on delayed scan
MRI
• Hypointense on T1
• Very bright on T2, ‘light bulb sign’
• Early peripheral nodular enhancement and central fill-in as for CT
NUCLEAR MEDICINE
• Low uptake on single photon emission computed tomography (SPECT) with technetium-labelled erythrocytes—the lesions fill in and demonstrate increased activity on delayed scan.
Hepatic haemangioma.
Dynamic post-contrast axial images from a magnetic resonance image of the liver. There is a lesion in the right hepatic lobe which shows early peripheral enhancement (a, b) and progressive centripetal fill-in (c, d).
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