What are the CT manifestations of hepatic hemangioma?

Although hepatic hemangioma is a benign disease, patients should pay attention to the correct way to deal with the occurrence of these diseases, try to reduce the harm caused by them, and actively undergo examinations. CT scan of hepatic hemangioma is a diagnostic method.

1. Hepatic hemangioma has characteristic manifestations on CT scans. Plain scans show almost uniform low-density shadows with clear boundaries and circular or elliptical shapes. Enhanced scans show lesions more clearly, and have characteristic nodular enhancement starting from the edge of the lesion and gradually extending to the center of the lesion until the contrast agent completely fills the lesion, showing a "slow appearance and slow regression" characteristic change. This characteristic manifestation is an important and reliable basis for diagnosing hepatic hemangioma, with a diagnostic consistency rate of over 95%. All cases in this group were diagnosed based on this sign.

2. The main CT signs of hepatic hemangioma are: single lesions are more common, the lesions are round or oval in shape, and irregular shapes are rare. The edges are mostly unclear, and the plain scan density is low, which is mostly uniform, and there is often a lower density in the center. In the early stage of enhanced scanning, the edge of the lesion showed high-density enhancement, and the enhanced area progressively expanded toward the center. Delayed scanning presents equal density filling, which is fast in and slow out. The plain scan and enhanced manifestations of hepatic hemangioma are very characteristic, which are closely related to its histological changes. In this group, the boundaries of lesions were mostly blurred in plain scans, which was related to the compression of perihepatic tissues and hepatic sinusoids. In this group, there were 39 cases with uniform density and 11 cases with uneven density, which may be related to the presence of scar fibers or thrombosis in the tumor. If the central low density does not enhance during enhancement, it indicates thrombosis or thrombus organization. Because the walls of the hemangioma cavity are mostly very thin, more contrast agent can enter, and there is a lack of muscle tissue in the cavity wall, so the contrast agent stays for a long time and can gradually diffuse. Therefore, enhanced CT scanning shows delayed filling of contrast agent, which may eventually show changes in density equal to that of the liver parenchyma. However, there are very few cases where CT enhancement is not obvious or not enhanced at all. This is because the wall of the tumor cavity is thick and the cavity is too small, so the contrast agent is difficult to enter or enters less. Some cases may present as mixed lesions with some parts being enhanced and some parts being not significantly enhanced, which is due to the fact that the tumor is composed of both thick-walled and thin-walled endotypes.

3. CT cross-sectional anatomical images have good density resolution, which can accurately identify and detect lesions and show the size, shape, number and relationship of lesions with surrounding organs. It can also measure the CT attenuation coefficient within the lesion. It is a non-invasive examination and is considered to be one of the most effective methods for distinguishing benign and malignant liver tumors.