Hepatic hemangioma

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	Hepatic hemangioma;
	Heptatic hemangioma. ; Image courtesy of RadsWiki

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Contributors: Cafer Zorkun M.D., PhD.

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Overview

Most common primary liver tumor
Ranges from 0.4-20% of the population
Arise from the endothelial cells that line the blood vessels and consists of multiple, large vascular channels lined by a single layer of endothelial cells and supported by collagenous walls.
They are frequently asymptomatic and incidentally discovered at imaging, surgery, or autopsy.
They may be associated with focal nodular hyperplasia.
M:F = 1:5
May be associated with Kasabach-Merritt syndrome: Hemolytic anemia and consumptive coagulopathy

Diagnosis

Ultrasonography

Echogenic
Homogenous

Computed Tomography

Noncontrast: Hypointense to liver
Portal venous enhancement: Peripheral nodular enhancement
Delayed enhancement: Lesion fills in the contrast

MRI

T2 hyperintense
Portal venous enhancement: Peripheral nodular enhancement
Delayed enhancement: Lesion fills in the contrast

Scintigraphy

Tc99-labeled red blood cells show decreased activity on early dynamic images and increased activity on delayed images (i.e. 1-2 hours).
Only sensitive for larger lesions.