Anastomosing hemangioma of the liver: An unusual variant in abdominal MRI imaging

Hepatic anastomosing hemangioma: description of a rare case and a literature analysis

“…However, in the 4 cases of their study, only 1 case showed high signal on DWI with low signal on the ADC map; another patient exhibited slight hyperintensity on both DWI and ADC, which was consistent with the diffusion features of our cases and was likely due to the T2 shine-through effect rather than true restricted diffusion; ADC maps of the remaining 2 cases were not provided. In the case reported by Rogers et al , hepatic AH demonstrated no restricted diffusion ( 10 ), which is similar to a recently published case of retroperitoneal AH ( 15 ). In a previously published hepatic AH case at our hospital ( 14 ), the lesion showed no obviously restricted diffusion, with a mean an ADC value of 1.81×10 -3 mm 2 /s.…”

“…On MRI, hepatic AHs typically demonstrate high intensity on T2WI and low intensity on T1WI, with similar enhancing presentation to that on CT ( 5 , 7 , 8 , 10 , 11 , 14 ). The most common enhancement patterns of reported hepatic AHs can be summarized into 2 distinct types: the first is homogeneous persistent hyperenhancement during arterial phase without subsequent washout in the portal venous or equilibrium phases ( 7 , 8 , 10 , 13 ), and the second type is a thick, continuous, rim-like enhancement in the arterial phase with progressively centripetal filling during the portal venous and equilibrium phases ( 5 , 7 , 11 , 14 ); the latter is consistent with our case. Central unenhanced areas in equilibrium or delayed phases are hypothesized to result from thrombosis or hyaline degeneration.…”

“…Approximately two-thirds of cases of hepatic AH undergo surgical resection, and no recurrence or metastasis has been reported in postoperative follow-up ranging from 6 to 96 months ( 3 , 6 , 11 ). In two 2 cases of hepatic AH diagnosed with biopsy and treated with microwave ablation, there was no evidence of tumor recurrence during follow-up ( 10 , 13 ). There have been no reported hemorrhagic complications (neither spontaneous nor postbiopsy) ( 2 ).…”

“…The lesions exhibit hypointensity in the hepatobiliary phase. There have been few published reports regarding the presentation of hepatic AHs on diffusion-weighted imaging (DWI) ( 7 , 10 ). Lunn et al reported restricted diffusion in hepatic AHs ( 7 ).…”

A growing liver anastomosing hemangioma

“…The limited available cases showed a slow growth of 5 mm within a 1-year period ( 7 ). These limited cases reported interval growth in which the lesion increased in size from 8 to 16 mm over 18 months ( 8 ). This case can guide existing understandings of the growth rate of AH in the liver.…”