Presentation
Hyperechoic liver mass incidentally found on abdominal US.
Patient Data
A hyperechoic mass measuring up to 2.9 cm is found in left liver lobe. After administration of ultrasound contrast media, it shows typical centripetal enhancement pattern characteristic of a hemangioma. In venous phase (starting around 0:35 seconds after contrast media application) persistent contrast accumulation is demonstrated, typical for benign liver lesions. This is a LI-RADS 1 lesion.
A hypodense mass is found in left liver lobe, showing centripetal, nodular postcontrast enhancement typical for liver hemangiomas.
Follow-up ultrasound of the same liver lesion in one-year period shows no change in size or enhancement pattern.
Case Discussion
Liver hemangiomas are benign liver tumors, consisting of cavities lined by epithelium and filled by blood vessels. They are supplied by hepatic artery and show early contrast enhancement, with characteristic centripetal nodular pattern (they enhance from outside towards the central part), with persistent enhancement in early and late venous phase. This allows differentiation from malignant tumors (which may have hyperechoic appearance on ultrasound), which usually show wash-out pattern in venous phase.
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