PMC9619328_01
Preprocedural axial T1-weighted contrast-enhanced MR demonstrates large hemangioma centered within the right hepatic lobe.
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It eventually grew from an initial size of 10 x 10 x 9 cm to 16 x 15 x 20 cm, replacing the entire right hepatic lobe and resulting in marked mass effect on inferior vena cava (IVC) (Fig. 1).
Selective arteriogram of the right hepatic artery demonstrates a large hypervascular mass occupying almost the totality of the right hepatic lobe (A). Postembolization images from the second procedure show decreased flow through the right hepatic artery and decreased vascular supply to the mass (B).
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The next treatment was performed one month later with the same mixture of bleomycin and lipiodol followed by a 3% Sodium tetradecyl sulfate (STS) foam made using a combination of agents with a 3:2:1 ratio of room air: 3% STS: lipiodol respectively (Fig. 2). The patient was admitted for overnight observation after each procedure. There were no immediate or delayed post procedure complications or adverse events.
T1-weighted contrast-enhanced MR 15 months following second embolization procedure shows significantly decreased size of the hemangioma centered within the right hepatic lobe.
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At that time, it measured 7 x 8 x 7 cm, with decreased mass effect upon the inferior vena cava and 90% reduction in volume (Fig. 3).