Hepatic Cavernous Hemangioma: Temporal Peritumoral Enhancement during Multiphase Dynamic MR Imaging1
Mi-Gyoung Jeong, MD,
Jeong-Sik Yu, MD and
Ki Whang Kim, MD
1 From the Department of Diagnostic Radiology and the Research Institute of Radiological Science, Yonsei University College of Medicine, YongDong Severance Hospital, 146-92, Dokok-Dong, Kangnam-Ku, Seoul 135-270, South Korea. Received April 27, 1999; revision requested June 14; final revision received January 10, 2000; accepted January 27. Address correspondence to J.S.Y. (e-mail: yjsrad97@yumc.yonsei.ac.kr).
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Figure 1a. Transverse multiphase gadolinium-enhanced FLASH MR images (113/4.1) obtained with fat suppression in a 45-year-old man with hemangioma. (a) Image obtained in the first phase shows a homogeneously enhanced small hemangioma (arrow) in segment 6. (b) Image obtained in the second phase shows that the area of parenchymal enhancement (arrow) adjacent to the hemangioma has a subcapsular wedge pattern. (c) Image obtained in the third phase shows that the peritumoral parenchymal enhancement is not discernible.
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Figure 1b. Transverse multiphase gadolinium-enhanced FLASH MR images (113/4.1) obtained with fat suppression in a 45-year-old man with hemangioma. (a) Image obtained in the first phase shows a homogeneously enhanced small hemangioma (arrow) in segment 6. (b) Image obtained in the second phase shows that the area of parenchymal enhancement (arrow) adjacent to the hemangioma has a subcapsular wedge pattern. (c) Image obtained in the third phase shows that the peritumoral parenchymal enhancement is not discernible.
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Figure 1c. Transverse multiphase gadolinium-enhanced FLASH MR images (113/4.1) obtained with fat suppression in a 45-year-old man with hemangioma. (a) Image obtained in the first phase shows a homogeneously enhanced small hemangioma (arrow) in segment 6. (b) Image obtained in the second phase shows that the area of parenchymal enhancement (arrow) adjacent to the hemangioma has a subcapsular wedge pattern. (c) Image obtained in the third phase shows that the peritumoral parenchymal enhancement is not discernible.
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Figure 2. Rapidity of enhancement was determined with transverse gadolinium-enhanced FLASH MR images (113/4.1) obtained during the early nonequilibrium phase (the earliest phase showing contrast material enhancement of the hepatic vein [arrowhead]). Hemangiomas were then categorized as having slow enhancement (open arrows), intermediate enhancement (small solid arrows), or rapid enhancement (large solid arrow).
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Figure 3a. Transverse multiphase gadolinium-enhanced FLASH MR images (113/4.1) demonstrate patterns of temporal parenchymal enhancement adjacent to the hemangioma. (a) Image obtained in the arterial phase shows early opacification of the draining vein (arrow) without parenchymal enhancement. (b) Image obtained in the arterial phase in a different patient than in a shows a rapidly enhancing hemangioma with early opacification of the draining vein (large arrow). The small arrow indicates a small hemangioma without peritumoral enhancement in the left lobe of the liver. (c) Image obtained in the nonequilibrium phase in the same patient as in b demonstrates subsequent homogeneous enhancement of the hemangioma with peritumoral subcapsular wedge enhancement (large arrow). The small arrow indicates a small hemangioma without peritumoral enhancement in the left lobe of the liver. (d) MR image obtained in the arterial phase in a different patient than in a or b shows a large hemangioma with intermediate enhancement and peritumoral parenchymal enhancement in a lobar distribution (arrows).
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Figure 3b. Transverse multiphase gadolinium-enhanced FLASH MR images (113/4.1) demonstrate patterns of temporal parenchymal enhancement adjacent to the hemangioma. (a) Image obtained in the arterial phase shows early opacification of the draining vein (arrow) without parenchymal enhancement. (b) Image obtained in the arterial phase in a different patient than in a shows a rapidly enhancing hemangioma with early opacification of the draining vein (large arrow). The small arrow indicates a small hemangioma without peritumoral enhancement in the left lobe of the liver. (c) Image obtained in the nonequilibrium phase in the same patient as in b demonstrates subsequent homogeneous enhancement of the hemangioma with peritumoral subcapsular wedge enhancement (large arrow). The small arrow indicates a small hemangioma without peritumoral enhancement in the left lobe of the liver. (d) MR image obtained in the arterial phase in a different patient than in a or b shows a large hemangioma with intermediate enhancement and peritumoral parenchymal enhancement in a lobar distribution (arrows).
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Figure 3c. Transverse multiphase gadolinium-enhanced FLASH MR images (113/4.1) demonstrate patterns of temporal parenchymal enhancement adjacent to the hemangioma. (a) Image obtained in the arterial phase shows early opacification of the draining vein (arrow) without parenchymal enhancement. (b) Image obtained in the arterial phase in a different patient than in a shows a rapidly enhancing hemangioma with early opacification of the draining vein (large arrow). The small arrow indicates a small hemangioma without peritumoral enhancement in the left lobe of the liver. (c) Image obtained in the nonequilibrium phase in the same patient as in b demonstrates subsequent homogeneous enhancement of the hemangioma with peritumoral subcapsular wedge enhancement (large arrow). The small arrow indicates a small hemangioma without peritumoral enhancement in the left lobe of the liver. (d) MR image obtained in the arterial phase in a different patient than in a or b shows a large hemangioma with intermediate enhancement and peritumoral parenchymal enhancement in a lobar distribution (arrows).
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Figure 3d. Transverse multiphase gadolinium-enhanced FLASH MR images (113/4.1) demonstrate patterns of temporal parenchymal enhancement adjacent to the hemangioma. (a) Image obtained in the arterial phase shows early opacification of the draining vein (arrow) without parenchymal enhancement. (b) Image obtained in the arterial phase in a different patient than in a shows a rapidly enhancing hemangioma with early opacification of the draining vein (large arrow). The small arrow indicates a small hemangioma without peritumoral enhancement in the left lobe of the liver. (c) Image obtained in the nonequilibrium phase in the same patient as in b demonstrates subsequent homogeneous enhancement of the hemangioma with peritumoral subcapsular wedge enhancement (large arrow). The small arrow indicates a small hemangioma without peritumoral enhancement in the left lobe of the liver. (d) MR image obtained in the arterial phase in a different patient than in a or b shows a large hemangioma with intermediate enhancement and peritumoral parenchymal enhancement in a lobar distribution (arrows).
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Figure 4. Transverse MR image (113/4.1) obtained during the first phase of a multiphasic gadolinium-enhanced FLASH sequence shows a small hemangioma (black arrow) with temporal peritumoral enhancement in a subcapsular wedge pattern (white arrows). Temporal parenchymal enhancement around a small hemangioma was always associated with rapid enhancement.
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Figure 5. Transverse multiphasic gadolinium-enhanced FLASH MR image (113/4.1) demonstrates a hemangioma with intermediate enhancement (black arrows) and temporal peritumoral parenchymal enhancement in a subcapsular wedge pattern (white arrows).
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Copyright © 2000 by the Radiological Society of North America.
