Fluid–fluid levels in giant cavernous hemangioma of the liver: CT and MRI demonstration

Obata, Sho; Matsunaga, Naofumi; Hayashi, Kuniaki; Ohtsubo, Mayumi; Morikawa, Toshie; Takahara, Osamu

doi:10.1007/s002619900411

Cited by 6 publications

(11 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The fluid-fluid level is not specific of haemangiomas and has been reported in other lesions, such as complicated cysts, ciliated foregut cysts, chronic haematomas, biliary cystadenomas, tumours with liquefactive necrosis or haemorrhage, and necrotic metastases [33]. In general, histopathologic correlation is necessary to confidently establish the diagnosis [7,[32][33][34].…”

Section: Uncommon Presentations Of Haemangiomasmentioning

confidence: 99%

Liver haemangioma: common and uncommon findings and how to improve the differential diagnosis

et al. 2007

View full text Add to dashboard Cite

Haemangiomas are common focal liver lesions, generally detected in the work-up of asymptomatic patients. From the pathological point of view, they can be classified as small (capillary) or large, with cavernous vascular spaces that may show thrombosis, calcifications and hyalinisation. The polymorphic imaging appearance of haemangiomas depends on their histological features and flow pattern. The widespread use of cross-sectional imaging has allowed an increased detection rate and a better characterisation of this benign tumour. Recent developments of ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) providing high spatial and temporal resolution, together with the use of new contrast agents and/or pulse sequences has broadened the spectrum of imaging findings, contributing to diagnostic refinement in difficult cases. The scope of the present article is to provide an overview of the range of appearances of haemangiomas, explored with recent crosssectional imaging modalities, emphasising its atypical findings as explored by temporally resolved contrast-enhanced imaging.

show abstract

Section: Uncommon Presentations Of Haemangiomasmentioning

confidence: 99%

Liver haemangioma: common and uncommon findings and how to improve the differential diagnosis

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Soyer et al demonstrated enhancement patterns of hemangiomas on subtraction MRI, which were high intensity relative to the hepatic parenchyma on arterial phase and progressive enhancement on the delayed phase (4). The previously reported cases of hemangiomas with fluid-fluid levels showed variable enhancement patterns such as absence of enhancement (2), relatively delayed peripheral nodular enhancement with centripetal progression (8,10), and early subtle peripheral enhancement with centripetal progression (9). In the present study, subtraction MRI with a 1, 3 and 10 min delay after contrast injection revealed nodular and progressive enhancement of the inferior layer.…”

Section: Discussionmentioning

confidence: 49%

“…Slow blood flow or stagnant blood in a large intercommunicating vascular pool baffled by incomplete septation results in the sedimentation of blood cells within the serum, thereby forming a fluid-fluid layer within the hemangioma (9). The superior layer consists of serum and the inferior layer consists of sedimentary blood cells (2,3,(8)(9)(10). This theory well explains the unique SI of a hemangioma with a fluid-fluid level on MRI.…”

Section: Discussionmentioning

confidence: 63%

“…The fluid-fluid level has been described in variable types of focal hepatic lesions such as complicated cysts, abscesses, chronic hematomas, biliary cystadenomas, tumors with liquefactive necrosis or hemorrhage, and necrotic metastases (2, 3). The fluid-fluid level within a hepatic hemangioma has been rarely reported (2,3,(8)(9)(10). All reported cases with a fluid-fluid level in hemangiomas were easily depicted on CT and MRI (2,3,(8)(9)(10).…”

Section: Discussionmentioning

confidence: 86%

“…The fluid-fluid level within a hepatic hemangioma has been rarely reported (2,3,(8)(9)(10). All reported cases with a fluid-fluid level in hemangiomas were easily depicted on CT and MRI (2,3,(8)(9)(10). US usually did not identify fluid-fluid levels because of background echogenicity, but fluid-fluid levels were demonstrated on US in one case reported by Ghai et al (9).…”

Section: Discussionmentioning

confidence: 95%

See 2 more Smart Citations

A Case Report of Multiple Cavernous Hemangiomas with Fluid-Fluid Levels: A Focus on the Radiologic Features of Dynamic MRI with Subtraction

Lee

Kim

Lee

et al. 2011

J Korean Soc Radiol

View full text Add to dashboard Cite

The radiologic features of hemangiomas are well established. The diagnostic features on contrast enhanced computed tomography (CT) or magnetic resonance imaging (MRI) include peripheral globular and gradual centripetal enhancement. In most cases, hemangiomas do not require a pathological examination. However, some hemangiomas show atypical radiologic features, such as poor gradual enhancement on sclerosing or hyalinized hemangioma and a fluid-fluid level within a hemangioma (1). The radiologic diagnosis of hemangioma with a fluid-fluid level remains problematic because the typical enhancement pattern of hemangioma is not found on CT and a fluid-fluid level can be reported in various hepatic lesions from malignant to benign tumors (2, 3). Recently, the gadolinium-enhanced dynamic MRI with subtraction has been introduced as a highly sensitive method in the depiction of a vascular pattern and subtle enhancement of focal hepatic lesions (4, 5). To the best of our knowledge, there has been no report about the imaging feature of dynamic MRI with subtraction in a hemangioma with a fluid-fluid level. Herein, multiple cavernous hemangiomas with fluidfluid levels in a patient are presented. Case ReportA 40-year-old man was referred for hepatic nodules detected on a routine health checkup. The man had no specific medical history or laboratory findings. Ultrasound (US) revealed three well-defined echogenic nodules in the right lobe of his liver (Fig. 1A). Their diameters were less than 2 cm (range; 0.9-2 cm). On multiphase enhanced CT, these nodules showed nonspecific subtle enhancement in three phases and subtle single layered attenuation difference between the inferior and superior layer. The inferior layer of all nodules showed higher attenuation than that of the superior layer ( Multiple cavernous hemangiomas with fluid-fluid levels were presented in a 40-year-old male patient. These hemangiomas showed nonspecific radiologic features on ultrasound and computed tomography, but gadolinium-enhanced magnetic resonance imaging (MRI) with subtraction revealed fluid-fluid levels with unique and different enhancement of the inferior and superior layer. This is the first case report of cavernous hemangiomas with fluid-fluid levels, containing radiologic features of dynamic MRI with subtraction.

show abstract

Multiple hepatic hemangiomas with fluid‐fluid levels

Lee

Lim

Jeon

2007

Australasian Radiology

View full text Add to dashboard Cite

Hepatic haemangiomas with fluid-fluid levels are known to be rare with only five cases reported in the English literature. According to the previous reports, the presence of fluid-fluid level could attribute to the separation of blood cells and serous fluid because of the extremely slow flow in cavernous haemangioma of the liver. We describe the imaging features of multiple hepatic haemangiomas with fluid-fluid levels, which was pathologically proven with ultrasonography guided biopsy.

show abstract

Fluid–fluid levels in giant cavernous hemangioma of the liver: CT and MRI demonstration

Cited by 6 publications

References 6 publications

Liver haemangioma: common and uncommon findings and how to improve the differential diagnosis

Liver haemangioma: common and uncommon findings and how to improve the differential diagnosis

A Case Report of Multiple Cavernous Hemangiomas with Fluid-Fluid Levels: A Focus on the Radiologic Features of Dynamic MRI with Subtraction

Multiple hepatic hemangiomas with fluid‐fluid levels

Contact Info

Product

Resources

About