PMC4168547_01
Dr. Alexandre Batista
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F1
68-year-old male referred to our hospital due to multifocal hepatic lesions, subsequently diagnosed as diffuse hepatic hemangiomatosis. a) Ultrasound examination demonstrates multiple ill-defined yperechoic nodules dispersed throughout the hepatic parenchyma, mostly sub-centimeter and with right hemi-liver predominance. Some nodules are larger and better defined (arrows). b) Color Doppler shows no evident vascularity in the lesion.
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F2
A discontinuous centripetal filling appearance was noted on larger lesions [Figure 2].
68-year-old male referred to our hospital due to multifocal hepatic lesions, subsequently diagnosed as diffuse hepatic hemangiomatosis. a) Axial fatsaturated T2-weighted image shows countless small-sized moderately bright lesions (arrows). b) Diffusion weighted image shows these lesions with high signal intensity (b = 600 sec/mm2) (arrows), which may be seen in liver hemangiomas secondary to T2 shine-through effect. Axial c) pre-contrast and (d-f) post-contrast fat-saturated T1-weighted images show arterial homogeneous enhancement (arrows, d), some exhibiting portal phase peripheral nodular enhancement (arrow, e) and late centripetal filling (arrows, f).
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F3
Pathology revealed endothelial-lined sinusoidal proliferation with erythrocyte content, consistent with hepatic hemangiomatosis [Figure 3].