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LIVER HAEMANGIOMAS

Liver Haemangioma

Haemangiomas are the most common benign tumour of the liver. More common in females. The prevalence in general population ranges from 2% to 20%.

The cause of Haemangiomas is unclear. It is consisting of blood-filled vascular cavities lined by endothelial cells.

Haemangiomas are often incidentally discovered during imaging and most patients are asymptomatic and require no treatment. Large Haemangiomas may cause symptoms secondary to extrinsic compression of adjacent organs.

MR Imaging features of typical Cavernous Haemangioma:

T1: homogenous hypointense
T2: homogenous markedly hyperintense(referred to as light bulb sign)
Post contrast: enhancement features depend on the size of the lesion, homogeneous arterial phase enhancement (<1.5 cm) or interrupted peripheral nodular enhancement (>1.5 cm) with centripetal progression to uniform enhancement
Hepatobiliary phase: hypointense.
DWI: hyper intense with low b values (T2 shine through). Iso-intesne with high b vaule and on ADC map.

T2 TSE FAT SAT AXIAL

T1 Vibe In Phase

T1 Vibe Out-Of-Phase

T2 TSE Axial TE 90

T2 TSE Axial TE 180

T1 Flash Axial Pre

T1 Flash Arterial Phase

T1 Flash Venous Phase

T1 Flash 10 Minutes

T1 Flash 20 Minutes

Reference:

  1. Semelka RC et-al. Hepatic hemangiomas: a multi-institutional study of
    appearance on T2-weighted and serial gadolinium-enhanced gradient-echo
    MR images. Radiology 1994; 192:401–406. 
  2. Nagihan Inan et-al.  Diffusion weighted MR imaging in the differential diagnosis of haemangiomas and metastases of the liver. Radiol Oncol. 2010 Mar; 44(1): 24–29.

Dr Rajapandian Ilangovan
Consultant Radiologist
Intestinal Imaging Centre | St Mark’s Hospital | London.