Department of Radiology, College of Medicine, The Catholic University of Korea, Korea.
Published online: January 1, 2001.
ABSTRACT
PURPOSE: To analyse small hepatic hemangiomas of less than 3cm in diameter, sonographic features with respects to their tumor size, and underlying liver diseases. MATERIALS & METHODS: This study consisted of 98 small hepatic hemangiomas of less than 3cm diameter in 82 patients. Hemangiomas were divided into 2 groups (group I: < 15mm, group II: 15-30mm) according to their sizes. According to their liver diseases, they were categorized as normal liver(n=61), acute and chronic hepatitis(n=4, n=13, respectively), liver cirrhosis(n=7), and fatty liver(n=13). Sonographic findings of hemangiomas involved internal echoes (hyperechoic, mixed echoic, isoechoic, and hypoechoic) and marginal echoes (echogenic rim and hypoechoic rim) and the frequency of typical and atypical sonographic findings were analyzed with respect to the size and underlying liver diseases. Hemangiomas were confirmed by at least any two combinations of 99mTc RBC SPECT, computed tomography, magnetic resonance imaging, and angiography. RESULTS: The mean size of 98 hemangiomas was 16.7mm. Sixty five(66.3%) of 98 hemangiomas showed typical sonographic finding as a well-defined homogeneous echogenic nodule without any peritumoral rim but 33 cases(33.7%) showed atypical sonographic findings with variable echo patterns. Echo pattern according to tumor size, atypical sonographic findings were ebserved in 17.8% of group I and in 47.2% of group II(p<0.001). Echo pattern according to underlying liver diseases was more variable in fatty liver and normal liver than in other liver diseases. Atypical sonographic findings were observed in 34.4% of normal liver cases. All hemangiomas noted in hepatitis and liver cirrhosis showed typical sonographic finding. Atypical sonographic findings were seen in 84.6% of hemangiomas noted in fatty livers, whih was nore frequently detected than in other liver diseases or normal liver cases(p<0.001). CONCLUSION: Even in small hepatic hemangiomas of less than 3cm, atypical sonographic findings are not uncommonly encountered, which are more frequently noted in larger tumor and in fatty liver. Echo changes of hemangiomas seems to be influenced by fatty infiltration in the liver and tumor size.
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