CASE 642 Published on 03.10.2000
0

Liver hemangiomas.

Section

Abdominal imaging

Case Type

Clinical Cases

Authors

Y. Gandon

Connected authors
Patient

39 years, male

Categories
No Area of Interest ; Imaging Technique CT
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Clinical History
Fortuitous discovery of multiple hyperechoic liver nodules.
Imaging Findings
Chronic abdominal pain. Ultrasound examination showed multiple hyperechoic liver nodules. Hepatic biology parameters were normal.
Discussion
Liver hemangiomas are very common. Usually they are frankly hyperechoic, well limited, except in case of underliyng liver steatosis. Diagnostic certitude, if there is some doubt after ultrasound, is better obtained by MRI giving structural information (hypersignal on T2-weighted sequences) together with dynamic enhancement. CT-scan is less efficient but can also show the centripetal progressive enhancement. The timing of enhancement is depending of the level of lesion vacularity, leading to different aspects from hypervascular lesions to hypodense lesions with a very slow enhancement. The presence of small periphal nodules at arterial phase.
Differential Diagnosis List
Liver hemangiomas.
Final Diagnosis
Liver hemangiomas.
Case information
URL: https://eurorad.org/case/642
DOI: 10.1594/EURORAD/CASE.642
ISSN: 1563-4086
Figure 1

Spiral CT-scan

Spiral CT-scan
Pre-contrast image showing two hypodenses nodules.
Spiral CT-scan
Pre-contrast image showing a third hypodense lesion.
Spiral CT-scan
Arterial phase image showing the pereipheral enhancement of the two lesions.
Spiral CT-scan
Arterial phase image showing the pereipheral enhancement of the third lesion wich is already almost filled-in.
Spiral CT-scan
Below the third lesion there is a hyperdensity in the adjacent liver which is very common in case of highly vascular hemangioma. This is correponding to a small arterio-venous shunt.
Spiral CT-scan
Progressive fill in of the upper lesions.
Spiral CT-scan
Centripetal enhancement of the third lesion.