Computed tomography in the diagnosis of cavernous hemangioma of the liver

Computed tomography (CT), using a sequential timed scanning technique, was performed on six patients with hepatic cavernous hemangiomas. Initial examination shows a moderately homogeneous circumscribed area with reduced attenuation values. Serial scans after injection of a bolus of contrast material show early peripheral opacification while the central part of the lesion retains low attenuation values for several minutes. Later scans demonstrate a variable degree of 'filling in' of the central part of the hemangioma. If the characteristic appearance of this lesion is recognized, confusion with other ominous lesions and biopsy can be avoided. Because of limited experience, the described pattern may not be absolutely pathognomonic for hemangioma, so angiography is currently advised to confirm the diagnosis.