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Fading hepatic hemangiomas on multiphasic CT.

Samira Alturkistany1, Hyun-Jung Jang, Hojun Yu

  • 1Department of Medical Imaging, University of Toronto, Toronto General Hospital, 585 University Avenue, Toronto, ON, M5G 2N2, Canada.

Abdominal Imaging
|December 7, 2011
PubMed
Summary

Fading hemangiomas, appearing less dense than the portal vein on CT scans, were observed in 16% of cases, particularly in flash-filling types. This finding is crucial for accurate diagnosis, as fading hemangiomas can mimic malignancy.

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Area of Science:

  • Radiology
  • Medical Imaging
  • Hepatobiliary Imaging

Background:

  • Hemangiomas are common benign liver tumors.
  • Characteristic enhancement patterns on multiphasic CT aid in diagnosis.
  • Fading hemangiomas present a diagnostic challenge due to decreased attenuation in later phases.

Purpose of the Study:

  • To characterize "fading" hemangiomas, defined by lower attenuation than the vascular pool in the portal venous phase (PVP) on multiphasic CT.
  • To determine the incidence and imaging features of these fading hemangiomas.

Main Methods:

  • 168 hemangiomas from 114 patients were analyzed using multiphasic CT.
  • Hemangioma and liver parenchyma attenuation, portal vein density, and enhancement patterns were measured.
  • Comparison of imaging features between fading and non-fading hemangiomas was performed.

Main Results:

  • 16% (27/168) of hemangiomas exhibited "fading" on PVP.
  • Fading was significantly more frequent in flash-filling hemangiomas (52%) compared to rapid (15%) and slow-filling (33.3%) types.
  • Fading hemangiomas were smaller (17.9 mm) than non-fading ones (24.2 mm).

Conclusions:

  • A significant proportion of hemangiomas demonstrate "fading" on PVP CT, especially flash-fillers.
  • Understanding this "fading" phenomenon is essential for accurate hemangioma diagnosis and differentiating from hypervascular malignancies.
  • The incidence of fading hemangiomas, particularly in flash-fillers, necessitates awareness among radiologists.