HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Brancatelli, G. Articles by Grazioli, L. Search for Related Content PubMed PubMed Citation Articles by Brancatelli, G. Articles by Grazioli, L.

Hemangioma in the Cirrhotic Liver: Diagnosis and Natural History¹

¹ From the Department of Radiology, University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop St, Rm 4660 CHP MT, Pittsburgh, PA 15213-2582 (G.B., M.P.F., A.B.); and Department of Radiology, Spedali Civili, University of Brescia, Italy (L.G.). Received June 20, 2000; revision requested July 24; revision received August 17; accepted August 31. G.B. supported by the Nicholas Green Fulbright Grant. Address correspondence to M.P.F. (e-mail: federle+@pitt.edu).

PURPOSE: To investigate the natural history and diagnosis of cavernous hemangioma in the cirrhotic liver with computed tomography (CT) and magnetic resonance (MR) imaging.

MATERIALS AND METHODS: Imaging and pathologic findings of 21 hemangiomas in 17 patients were retrospectively reviewed. CT of the liver was performed in all patients; MR imaging, in four. Cirrhosis was confirmed histologically in all patients, and the diagnosis of hemangioma was based on histopathologic findings (15 patients, 18 hemangiomas) or strict imaging criteria (two patients, three hemangiomas). Ten patients underwent imaging follow-up. The number, sizes, location, attenuation, pattern of enhancement, exophytic growth, presence of capsular retraction, and size stability were evaluated.

RESULTS: Of the 21 hemangiomas, five were not detected at CT or MR imaging. Twelve (75%) of 16 hemangiomas were subcapsular, two (12%) of 16 demonstrated exophytic growth, 14 (87%) of 16 demonstrated nodular peripheral enhancement, and 16 (100%) of 16 were isoattenuating to blood vessels. At MR imaging, all five hemangiomas demonstrated nodular peripheral enhancement and hyperintensity on T2-weighted images. Seven lesions were smaller at follow-up, and five lesions developed retraction of the hepatic capsule.

CONCLUSION: Even within the cirrhotic liver, larger hemangiomas can usually be diagnosed confidently with CT or MR imaging. With progressive cirrhosis, however, hemangiomas are likely to decrease in size, become more fibrotic, and are difficult to diagnose radiologically and pathologically.

Index terms: Angioma, gastrointestinal tract, 761.3194 • Liver, cirrhosis, 761.794 • Liver neoplasms, CT, 761.12111, 761.12112, 761.12114, 761.12115 • Liver neoplasms, diagnosis, 761.3194 • Liver neoplasms, MR, 761.121411, 761.12143

This article has been cited by other articles:

				S. H. Kim, J. M. Lee, J. Y. Lee, J. K. Han, S. K. An, C. J. Han, K. H. Lee, S. S. Hwang, and B. I. Choi Value of Contrast-Enhanced Sonography for the Characterization of Focal Hepatic Lesions in Patients with Diffuse Liver Disease: Receiver Operating Characteristic Analysis Am. J. Roentgenol., April 1, 2005; 184(4): 1077 - 1084. [Abstract] [Full Text] [PDF]

				J A Guthrie Cirrhosis and focal liver lesions: MRI findings Imaging, September 1, 2004; 16(4): 351 - 363. [Abstract] [Full Text] [PDF]

				T. H. Bryant, M. J. Blomley, T. Albrecht, P. S. Sidhu, E. L. S. Leen, R. Basilico, J. M. Pilcher, L. H. Bushby, C. W. Hoffmann, C. J. Harvey, et al. Improved Characterization of Liver Lesions with Liver-Phase Uptake of Liver-specific Microbubbles: Prospective Multicenter Study Radiology, September 1, 2004; 232(3): 799 - 809. [Abstract] [Full Text] [PDF]

				F. M. Fennessy, K. J. Mortele, T. Kluckert, A. Gogate, S. Ondategui-Parra, P. Ros, and S. G. Silverman Hepatic Capsular Retraction in Metastatic Carcinoma of the Breast Occurring with Increase or Decrease in Size of Subjacent Metastasis Am. J. Roentgenol., March 1, 2004; 182(3): 651 - 655. [Abstract] [Full Text] [PDF]

				V. Vilgrain, F. Uzan, G. Brancatelli, M. P. Federle, M. Zappa, and Y. Menu Prevalence of Hepatic Hemangioma in Patients with Focal Nodular Hyperplasia: MR Imaging Analysis Radiology, October 1, 2003; 229(1): 75 - 79. [Abstract] [Full Text] [PDF]

				G. Brancatelli, R. L. Baron, M. S. Peterson, and W. Marsh Helical CT Screening for Hepatocellular Carcinoma in Patients with Cirrhosis: Frequency and Causes of False-Positive Interpretation Am. J. Roentgenol., April 1, 2003; 180(4): 1007 - 1014. [Abstract] [Full Text] [PDF]

				S. A. Teefey, C. C. Hildeboldt, F. Dehdashti, B. A. Siegel, M. G. Peters, J. P. Heiken, J. J. Brown, E. G. McFarland, W. D. Middleton, D. M. Balfe, et al. Detection of Primary Hepatic Malignancy in Liver Transplant Candidates: Prospective Comparison of CT, MR Imaging, US, and PET Radiology, February 1, 2003; 226(2): 533 - 542. [Abstract] [Full Text] [PDF]

				H.-J. Jang, T. K. Kim, H. K. Lim, S. J. Park, J. S. Sim, H. Y. Kim, and J.-H. Lee Hepatic Hemangioma: Atypical Appearances on CT, MR Imaging, and Sonography Am. J. Roentgenol., January 1, 2003; 180(1): 135 - 141. [Full Text] [PDF]