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Abdomen » Liver & Biliary System
Hemangioma of the liver
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Presentation The patient is a 53 y.o male smoker with findings of suspicious opacity on a chest plain film.
 
 
 
Caption: CT scan
Description: Unenhanced CT scan found a 20 mm nodule in the segment IV of the liver
 
 
 
Caption: Transverse scan of liver
Description: Ultrasound of the lesion demonstrated on CT shows a predominately hyperechoic mass with mixed echogenicity, edge shadows and no significant posterior enhancement.
 
 
 
Caption: Baseline prior to injection of ultrasound contrast agent
Description: The lesion appears slightly hyperechoic at baseline US
 
 
 
Caption: Post injection 1
Description: After contrast agent injection there is peripheral globular enhancement and centripetal filling-in of the lesion,
 
 
 
Caption: Post injection 2
Description: There is a continuation of peripheral globular enhancement and centripetal filling-in of the lesion with no wash-out.
 
 
Caption: Video clip
Description: After Sonovue injection, we observe peripheral globular enhancement and centripetal filling-in of the lesion with no wash-out. This enhancement pattern is characteristic of Hemangioma.
 
Differential Diagnosis After CT and US: Metastasis, hemangioma, HCC, cholangiocarcinoma, adenoma
 
Final Diagnosis Hemangioma of the liver
 
Discussion The lesion appears slightly hyperechoic at baseline ultrasound.
After contrast agent injection, we observe peripheral globular enhancement and centripetal filling-in of the lesion with no wash-out.
This enhancement pattern is characteristic of Hemangioma.
 
Technical Details Contrast agent:  Sonovue, Bracco Inc.   
 
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