Hepatic Cavernous Hemangioma

MRI can distinguish between malignant lesions and cavernous hemangiomas in nearly all cases.
   
Heavily T2-weighted image shows a well defined liver lesion (arrow) that is much brighter than the spleen (S). A malignant lesion would have signal intensity similar to or less than that of the spleen.

 

Unenhanced T1-weighted fat suppressed image.

   
T1-weighted fat suppressed image about 30 seconds after intravenous injection of gadolinium contrast agent. There is some nodular enhancement at the periphery of the lesion.
 
About 5 minutes after injection of gadolinium contrast agent, most of the lesion has enhanced. Progressive nodular enhancement is only seen with cavernous hemangiomas, not malignant masses.


References

1. Ito K, Mitchell DG, Outwater EK, Szklaruk J, Sadek AG. Hepatic lesions: Discrimination of nonsolid, benign lesions from solid, malignant lesions with heavily T2-weighted fast spin-echo MR imaging. Radiology 1997;204:729-737.

2. Semelka RC, Worawattanakul S, Kelekis NL, et al. Liver lesion detection, characterization, and effect on patient management: comparison of single-phase spiral CT and current MR techniques. JMRI 1997;7:1040-1047.


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