SONOWORLD : Hemangioma of the liver ultrasound case

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Other » Contrast Agents

Hemangioma of the liver CEUS

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Author(s) :

Carla Serra, MD

M. Luigia Cipollini, MD

Presentation Patient with a known hyperechoic focal liver lesion, for CEUS study to characterize lesion.

Caption: Sagittal liver

Description: A large predominantly hyperechoic lesion is seen in the liver.

Caption: Post contrast injection: Arterial phase

Description: In the arterial phase a globular enhancement is visible at the margin of the lesion, slowly progressing centripetally towards the center of the lesion.

Caption: Portal-venous Phase

Description: In the portal-venous phase the lesion shows progressing contrast fill-in, becoming completely enhanced in the late phase.

Caption: Contrast-enhanced ultrasound video clip.

Description:

Differential Diagnosis Metastasis, hemangioma, HCC, cholangiocarcinoma, adenoma

Final Diagnosis Hemangioma

Discussion This lesion exhibits a typical enhancement pattern of hemangioma. Arterial phase: peripheral-nodular enhancement, no central enhancement. In PV phase: partial/complete centripetal filling. In Late phase: complete enhancement of lesion.

Variations include rim enhancement in the arterial phase, and for small lesions, complete rapid centripetal enhancement.
Hemangiomas may have non-enhancing areas in late phase. (1)

Case References 1. EFSUMB study group et al.: Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) - Update 2008 http://www.efsumb.org/mediafiles01/ceus-guidelines2008.pdf

Technical Details Contrast Agent: SonoVue (Bracco)

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