Cavernous hemangioma

Cavernous hemangioma is the most common benign tumor of the liver. It is reported with an incidence of 20% in the general population. It is also a frequent incidental finding in the investigation of other diseases and is mostly asymptomatic.

MRI appearance of a cavernous hemangioma without (pre-contrast) and with Primovist^®

MRI represents the ideal diagnostic tool when characterizing hemangiomas. Hemangiomas have low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Hemangiomas have a well-defined lobular border (left-hand-side).

In the liver-specific phase, 20 min after Primovist^® administration, hemangiomas are hypointense (dark areas) to the surrounding parenchyma and do not show an uptake of the agent (right-hand-side).

Cavernous hemangioma

Precontrast: T1-weighted: hypointense lesion vs. liver parenchyma

After injection, T1-weighted, liver-specific phase: hypointense lesion

Therapy

If there is concern regarding rupture, the lesions can be excised quite safely by an experienced liver surgeon familiar with hepatic malformations. More often than not, conservative medical observation is advised (imaging follow-up) in order to observe growth. Other treatment options are embolization and steroids.