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Hypervascular liver lesions

Hypervascular liver lesions may be caused by primary liver pathology or metastatic disease.

Primary lesions
  • hepatocellular carcinoma (HCC)
    • most common hypervascular primary liver malignancy
  • haemangioma
    • benign; most common liver tumor overall
    • discontinuous, nodular, peripheral enhancement starting in arterial phase
    • gradual central filling in
    • enhancement must match blood pool in each phase, or not a hemangioma (ie, similar to aorta in arterial, portal vein in portal phase, etc)
    • small haemangiomas (< ~1.5 cm) may demonstrate "flash filling" - complete homogenous enhancement in arterial phase (no gradual filling in)
  • focal nodular hyperplasia (FNH)
  • hepatic adenoma
  • primary hepatic carcinoid

Although the majority of liver metastases are hypodense and enhance less than the surrounding liver, metastases from certain primaries demonstrate an increase in the number of vessels, resulting in a hyperechoic ultrasound appearance, and arterial phase hyperenhancement on CT or MRI. The primaries typically include:

Other secondary lesions

See also

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