Cavernous hemangioma of the liver: Pathologic correlation with dynamic CT findings

PURPOSE: To correlate the pathologic findings of cavernous hemangiomas with enhancement patterns seen at dynamic computed tomography (CT) performed after injection of contrast material. MATERIALS AND METHODS: Sixteen patients underwent dynamic CT followed by hepatectomy. Resected specimens of 16 cavernous hemangiomas, which ranged from 2 to 15 cm in diameter, were obtained. The average size of vascular spaces in the histologic specimen was correlated with their appearance on dynamic CT scans. RESULTS: In 11 tumors, characteristic progressive fill-in after peripheral contrast enhancement was seen (type 1). In type 1 tumors, three zones were noted within the tumor: areas of peripheral puddling in the arterial-dominant phase, areas of gradual fill-in, and areas of no or minimal enhancement. Vascular spaces in areas of peripheral global enhancement were significantly smaller than those in areas of gradual fill-in (P = .03). In areas of no or minimal enhancement, extensive scar tissue (n = 9) or cystic cavity (n = 3) was seen. In three hemangiomas smaller than 3 cm, enhancement occurred diffusely in the arterial-dominant phase and vascular space was small (type 2). In two tumors, enhancement was seen only in the periphery of the tumor (type 3), and the majority of tumor was occupied by the cystic cavity or scar tissue. CONCLUSION: Dynamic enhancement patterns of cavernous hemangiomas are related to the collective size of their constituent vascular spaces.