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Gastrointestinal
Diagnosis
Liver
Benign Neoplasms and Tumor-like Conditionas
Hepatic Cavernous Hemangioma
Hepatic Cavernous Hemangioma
Atif Zaheer, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Cavernous hemangioma of liver
            • Capillary hemangioma (small lesion)

          • Definitions

            • Benign tumor composed of multiple vascular channels lined by single layer of endothelial cells supported by thin, fibrous stroma

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Angiographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Kim YY et al: Gadoxetic acid-enhanced MRI for differentiating hepatic sclerosing hemangioma from malignant tumor. Eur J Radiol. 135:109474, 2021
                                            2. Song S et al: Hypervascular hepatic focal lesions on dynamic contrast-enhanced CT: preliminary data from arterial phase scans texture analysis for classification. Clin Radiol. 74(8):653.e11-8, 2019
                                            3. Al Farai A et al: Giant pedunculated hepatic hemangioma: a case report and literature review. Case Rep Oncol. 11(2):476-84, 2018
                                            4. Choi J et al: Hepatic cavernous hemangiomas: long-term (> 5 years) follow-up changes on contrast-enhanced dynamic computed tomography or magnetic resonance imaging and determinant factors of the size change. Radiol Med. 123(5):323-30, 2018
                                            5. Grazioli L et al: Primary benign liver lesions. Eur J Radiol. 95:378-98, 2017
                                            6. Husainy MA et al: Typical and atypical benign liver lesions: a review. Clin Imaging. 44:79-91, 2017
                                            7. Thampy R et al: Imaging features of rare mesenchymal liver tumors: beyond hemangiomas. Br J Radiol. 20170373, 2017
                                            8. Miyamoto S et al: Hepatic sclerosed hemangioma: a case report and review of the literature. BMC Surg. 15:45, 2015
                                            9. Cogley JR et al: MR imaging of benign focal liver lesions. Radiol Clin North Am. 52(4):657-82, 2014
                                            10. Klotz T et al: Hepatic haemangioma: common and uncommon imaging features. Diagn Interv Imaging. 94(9):849-59, 2013
                                            11. Marin D et al: Focal nodular hyperplasia-like lesions in patients with cavernous transformation of the portal vein: prevalence, MR findings and natural history. Eur Radiol. 21(10):2074-82, 2011
                                            12. Szurowska E et al: Is hepatotropic contrast enhanced MR a more effective method in differential diagnosis of hemangioma than multi-phase CT and unenhanced MR? BMC Gastroenterol. 11:43, 2011
                                            13. van Malenstein H et al: Giant liver hemangioma: the role of female sex hormones and treatment. Eur J Gastroenterol Hepatol. 23(5):438-43, 2011
                                            14. Colagrande S et al: Transient hepatic attenuation differences and focal liver lesions: sump effect due to primary arterial hyperperfusion. J Comput Assist Tomogr. 33(2):259-65, 2009
                                            15. Sugimoto K et al: Computer-aided diagnosis of focal liver lesions by use of physicians' subjective classification of echogenic patterns in baseline and contrast-enhanced ultrasonography. Acad Radiol. 16(4):401-11, 2009
                                            16. Erturk SM et al: Diffusion-weighted magnetic resonance imaging for characterization of focal liver masses: impact of parallel imaging (SENSE) and b value. J Comput Assist Tomogr. 32(6):865-71, 2008
                                            17. Regier TS et al: Pediatric hepatic hemangioma. Radiographics. 24(6):1719-24, 2004
                                            18. Danet IM et al: Giant hemangioma of the liver: MR imaging characteristics in 24 patients. Magn Reson Imaging. 21(2):95-101, 2003
                                            19. Kumano S et al: Using superparamagnetic iron oxide-enhanced MRI to differentiate metastatic hepatic tumors and nonsolid benign lesions. AJR Am J Roentgenol. 181(5):1335-9, 2003
                                            20. Brancatelli G et al: Hemangioma in the cirrhotic liver: diagnosis and natural history. Radiology. 219(1):69-74, 2001
                                            21. Kim T et al: Discrimination of small hepatic hemangiomas from hypervascular malignant tumors smaller than 3 cm with three-phase helical CT. Radiology. 219(3):699-706, 2001
                                            22. Jeong MG et al: Hepatic cavernous hemangioma: temporal peritumoral enhancement during multiphase dynamic MR imaging. Radiology. 216(3):692-7, 2000
                                            23. Vilgrain V et al: Imaging of atypical hemangiomas of the liver with pathologic correlation. Radiographics. 20(2):379-97, 2000
                                            24. Leslie DF et al: Distinction between cavernous hemangiomas of the liver and hepatic metastases on CT: value of contrast enhancement patterns. AJR Am J Roentgenol. 164(3):625-9, 1995
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Cavernous hemangioma of liver
                                                      • Capillary hemangioma (small lesion)

                                                    • Definitions

                                                      • Benign tumor composed of multiple vascular channels lined by single layer of endothelial cells supported by thin, fibrous stroma

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Angiographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Kim YY et al: Gadoxetic acid-enhanced MRI for differentiating hepatic sclerosing hemangioma from malignant tumor. Eur J Radiol. 135:109474, 2021
                                                                                      2. Song S et al: Hypervascular hepatic focal lesions on dynamic contrast-enhanced CT: preliminary data from arterial phase scans texture analysis for classification. Clin Radiol. 74(8):653.e11-8, 2019
                                                                                      3. Al Farai A et al: Giant pedunculated hepatic hemangioma: a case report and literature review. Case Rep Oncol. 11(2):476-84, 2018
                                                                                      4. Choi J et al: Hepatic cavernous hemangiomas: long-term (> 5 years) follow-up changes on contrast-enhanced dynamic computed tomography or magnetic resonance imaging and determinant factors of the size change. Radiol Med. 123(5):323-30, 2018
                                                                                      5. Grazioli L et al: Primary benign liver lesions. Eur J Radiol. 95:378-98, 2017
                                                                                      6. Husainy MA et al: Typical and atypical benign liver lesions: a review. Clin Imaging. 44:79-91, 2017
                                                                                      7. Thampy R et al: Imaging features of rare mesenchymal liver tumors: beyond hemangiomas. Br J Radiol. 20170373, 2017
                                                                                      8. Miyamoto S et al: Hepatic sclerosed hemangioma: a case report and review of the literature. BMC Surg. 15:45, 2015
                                                                                      9. Cogley JR et al: MR imaging of benign focal liver lesions. Radiol Clin North Am. 52(4):657-82, 2014
                                                                                      10. Klotz T et al: Hepatic haemangioma: common and uncommon imaging features. Diagn Interv Imaging. 94(9):849-59, 2013
                                                                                      11. Marin D et al: Focal nodular hyperplasia-like lesions in patients with cavernous transformation of the portal vein: prevalence, MR findings and natural history. Eur Radiol. 21(10):2074-82, 2011
                                                                                      12. Szurowska E et al: Is hepatotropic contrast enhanced MR a more effective method in differential diagnosis of hemangioma than multi-phase CT and unenhanced MR? BMC Gastroenterol. 11:43, 2011
                                                                                      13. van Malenstein H et al: Giant liver hemangioma: the role of female sex hormones and treatment. Eur J Gastroenterol Hepatol. 23(5):438-43, 2011
                                                                                      14. Colagrande S et al: Transient hepatic attenuation differences and focal liver lesions: sump effect due to primary arterial hyperperfusion. J Comput Assist Tomogr. 33(2):259-65, 2009
                                                                                      15. Sugimoto K et al: Computer-aided diagnosis of focal liver lesions by use of physicians' subjective classification of echogenic patterns in baseline and contrast-enhanced ultrasonography. Acad Radiol. 16(4):401-11, 2009
                                                                                      16. Erturk SM et al: Diffusion-weighted magnetic resonance imaging for characterization of focal liver masses: impact of parallel imaging (SENSE) and b value. J Comput Assist Tomogr. 32(6):865-71, 2008
                                                                                      17. Regier TS et al: Pediatric hepatic hemangioma. Radiographics. 24(6):1719-24, 2004
                                                                                      18. Danet IM et al: Giant hemangioma of the liver: MR imaging characteristics in 24 patients. Magn Reson Imaging. 21(2):95-101, 2003
                                                                                      19. Kumano S et al: Using superparamagnetic iron oxide-enhanced MRI to differentiate metastatic hepatic tumors and nonsolid benign lesions. AJR Am J Roentgenol. 181(5):1335-9, 2003
                                                                                      20. Brancatelli G et al: Hemangioma in the cirrhotic liver: diagnosis and natural history. Radiology. 219(1):69-74, 2001
                                                                                      21. Kim T et al: Discrimination of small hepatic hemangiomas from hypervascular malignant tumors smaller than 3 cm with three-phase helical CT. Radiology. 219(3):699-706, 2001
                                                                                      22. Jeong MG et al: Hepatic cavernous hemangioma: temporal peritumoral enhancement during multiphase dynamic MR imaging. Radiology. 216(3):692-7, 2000
                                                                                      23. Vilgrain V et al: Imaging of atypical hemangiomas of the liver with pathologic correlation. Radiographics. 20(2):379-97, 2000
                                                                                      24. Leslie DF et al: Distinction between cavernous hemangiomas of the liver and hepatic metastases on CT: value of contrast enhancement patterns. AJR Am J Roentgenol. 164(3):625-9, 1995