HEPATIC HEMANGIOMA - FINDINGS WITH 2-PHASE CT

PURPOSE: To characterize the appearance of hemangiomas at two-phase dynamic incremental computed tomography (CT) and to determine the cause of contrast material enhancement of adjacent parenchyma in the first series. MATERIALS AND METHODS: Contrast-enhanced CT images of 51 hemangiomas in 20 patients were reviewed. Enhancement patterns of hemangiomas in the first series were classified as homogeneous high, peripheral high, and low attenuation; in the second series, as homogeneous high, peripheral high, iso-, and low attenuation. Correlations between arterioportal shunts and early parenchymal enhancement were evaluated in 45 hemangiomas in the 17 patients who underwent angiography. RESULTS: Thirty-two hemangiomas progressively became enhanced. Four had low and eight had homogeneous high attenuation in both series. Seven changed from homogeneous high to isoattenuation. Early parenchymal enhancement was well correlated with presence of arterioportal shunt. CONCLUSION Low-attenuation hemangiomas and those that changed from homogeneous high to isoattenuation are atypical and difficult to differentiate from other neoplasms. Most early parenchymal enhancement is caused by associated arterioportal shunts.