February 11, 2012

Hepatic Hemangioma: MR Findings

Axial MR images show a large left hepatic lobe mass that has a very high T2 signal intensity and peripheral nodular contrast enhancement and incomplete delayed fill-in.

Facts:
  • Most common benign hepatic tumor
  • Female:male ratio = 2:1 to 5:1
  • Most are asymptomatic and found incidentally on imaging exams
  • US, CT, MRI and nuclear medicine scan may demonstrate hemangioma
  • Routine MR protocol for characterizing liver lesions = T1, FSE T2 (with fat suppression), dynamic gadolinium enhancement
MR Imaging Findings
  • A mass with T1 hypointensity, strong T2 hyperintensity with a "light bulb" pattern on heavily T2W sequence
  • Dynamic enhancement shows peripheral nodular enhancement (the nodules do not contact each other) with progressive centripetal enhancement. The inner ring of the enhancement is undulating.
  • Washout phase: persistent homogeneous enhancement without heterogeneous or peripheral washout
  • Small lesions may demonstrate homogeneous arterial enhancement but the enhancement will be persistent and homogeneous in washout phase.
Reference:
Lencioni R, Cioni D, Iartolozzi C. Focal liver lesions: detection, characterization, ablation. 2005

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