Hepatic Hemangioma: MR Findings

Axial MR images show a large left hepatic lobe mass that has a very high T2 signal intensity and peripheral nodular contrast enhancement and incomplete delayed fill-in.

Facts:

• Most common benign hepatic tumor
• Female:male ratio = 2:1 to 5:1
• Most are asymptomatic and found incidentally on imaging exams
• US, CT, MRI and nuclear medicine scan may demonstrate hemangioma
• Routine MR protocol for characterizing liver lesions = T1, FSE T2 (with fat suppression), dynamic gadolinium enhancement

MR Imaging Findings

• A mass with T1 hypointensity, strong T2 hyperintensity with a "light bulb" pattern on heavily T2W sequence
• Dynamic enhancement shows peripheral nodular enhancement (the nodules do not contact each other) with progressive centripetal enhancement. The inner ring of the enhancement is undulating.
• Washout phase: persistent homogeneous enhancement without heterogeneous or peripheral washout
• Small lesions may demonstrate homogeneous arterial enhancement but the enhancement will be persistent and homogeneous in washout phase.

Reference:

Lencioni R, Cioni D, Iartolozzi C. Focal liver lesions: detection, characterization, ablation. 2005