Department of Diagnostic Radiology, Yonsei University, College of Medicine, Department of Diagnostic Radiology, Aju Univeristy, College of Medicine
ABSTRACT
PBJECT : Typical cavernous hemangioma presents no diagnostic difficulty at sonography. However, in cases ofatypical hemangioma, further evaluation is needed to differentiate it from malignancy. On the other hand, thcechogenicity of the lesion may be isoecho or hypoecho when it occurs in association with fatty liver. We analyzedthe sonographic features of hemangioma in fatty liver. MATERIAL & METHODS : We reviewed the sonograms of 22lesions from 19 patients. We divided the lesions into two groups; the lesion measuring less than 3cm in diameter{group Ⅰ) and the lesions measuring same or greater than 3cm (group Ⅱ). The lesions of each group were analyzedin terms of location, shape, distinction of margin, internal echogenicity, posterior enhancement, lateralshadowing, and peritumoral hypoechoic halo. RESULTS : The lesions were located in subcapsular or perivascular areain 86%. They strowed round or lobulated shape with well defined margin in 82%. Internal echo of the lesions washypoechoic in 82% and homogeneous in 64%. Posterior enhancement was seen in 77%. The posterior wall of the lesionwas distinct in 68%. There was no statistical difference in incidence of each finding described above between thetwo groups except the internal echogenicity(p<0.05). All of the four hyperechoic lesions measured greater than 3cmin diameter, and three of them showcd uneven thickness of echogenic rind. Definitive diagnosis of hemangioma couldbe obtained in 82%. In remaining 18% of hemangioma, the lesions showed peripheral hypoechoic halo and lateralshadowing that made the diagnosis of hemangioma difficult. However, the possibility of hemangioma could besuggested because they showed homogneoues internal echogenicity and posterior enhancement. CONCLUSION : Hepaticcavernous hemangioma presents with variable echogenicity as compared to the surrounding tissue when it isassociated with fatty liver disease, Thus, in differentiating hemangiomas from other localized hepatic mass, othercharacteristics such as homogeneity of the internal echo, posterior enhancement, and hyperechoic peripheral rindshould be carefully analyzed.
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