Hyalinised hepatic hemangioma

Dr Henry Knipe and Dr Matt A. Morgan et al.

Hyalinised hepatic hemangiomas, also known as sclerosing/sclerosed hepatic hemangiomas, are a rare variant of hepatic hemangioma. Because of their unusual imaging features, they cannot be reliably differentiated from a malignant tumor without a biopsy. Liver capsular retraction is a common feature of these lesions. 

A hyalinised hemangioma differs from a typical hemangioma by containing extensive fibrous tissue and obliterated/thrombosed vascular channels. Some consider a hyalinisation to be a stage in hemangioma involution. A hemangioma that is only partially fibrosed is described as "sclerosing". A completely fibrosed hemangioma is described as "sclerosed".

  • T1: hypointense
  • T2: variable T2 signal intensity, less than that of a typical hemangioma
    • increasing sclerosis/fibrosis appears to correspond with increasing T2 hypointensity
  • T1+C (Gd)
    • absent or mild arterial phase-contrast enhancement
      • decreased enhancement with more advanced sclerosis
    • slight peripheral enhancement may occur in the late phase
    • peripheral enhancement is usually a thin rim, compared with nodular discontinuous enhancement
  • T1+C (Eovist): not described

Capsular retraction has been described in some hyalinised/sclerotic hemangiomas. Wedge-shaped transient hepatic intensity differences (THIDs) may be present in the adjacent liver.

A hyalinised hemangioma cannot be reliably be differentiated from a hepatic malignancy on MRI, and biopsy is necessary for differentiation 4.

Article information

rID: 33210
Synonyms or Alternate Spellings:
  • Sclerosing hemangioma
  • Hyalinized hemangioma
  • Sclerosed haemangioma
  • Sclerosed hemangioma
  • Hyalinized hepatic haemangioma
  • Hyalinized hepatic haemangiomata

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