Slow filling cavernous liver hemangioma (CEUS)

Case contributed by Akos Jaray
Diagnosis certain

Presentation

Referred with iron deficiency anemia. Indeterminate, hypoattenuating liver lesion on portal venous phase CT.

Patient Data

Age: 85 years
Gender: Female

Homogeneous, hyperechoic lesion of 4 cm in the right liver lobe on conventional ultrasound.

No obvious vascularity on color Doppler imaging.

Irregular, peripheral early arterial contrast enhancement (CEUS video).

Followed by continuous centripetal filling, that is incomplete even in the late phase.

Case Discussion

Typical cavernous hemangioma with a central non-enhancing area.

The arterial enhancement pattern is pathognomonic on contrast-enhanced ultrasound.

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