[Diagnosis of neonatal liver hemangioma]

The hepatic hemangiomas of infancy are rare, benign vascular tumours, differentiated in their morphologic and clinical appearances. They may manifest either as asymptomatic liver masses, or with the potentially fatal complication of congestive heart failure. They can be large in infancy, act as arteriovenous fistulas and may result in massive arteriovenous shunt. Multiple imaging modalities have been employed in the diagnosis, including ultrasonography (US), computed tomography (CT), radionuclide studies, angiography, magnetic resonance (MR) imaging. Generally the US, Doppler and CT appearances of hepatic hemangiomas may be diagnostic. Biopsy in often needed for diagnosis, especially if classic signs and symptoms are lacking. The diagnostic possibilities and difficulties in three patients are discussed. Different US images were present in all three cases, with atypical CT appearance in one. Doppler signals were lacking in two cases. Sonographic appearance of infantile hepatic hemangioma is variable, non-specific, but Doppler US is useful as a non-invasive method in the follow-up of hemangiomas.