page_title: Ultrasonography of liver tumors
section_title: Hemangioma
hierarchical_section_title: Ultrasonography of liver tumors / Benign liver tumors / Hemangioma
caption_attribution_description: English: Ultrasound of a hepatic hemangioma.
context_page_description: Ultrasonography of liver tumors involves two stages: detection and characterization.
  Tumor detection is based on the performance of the method and should include morphometric information and topographic information. The specification of these data is important for staging liver tumors and prognosis.
  Tumor characterization is a complex process based on a sum of criteria leading towards tumor nature definition. Often, other diagnostic procedures, especially interventional ones are no longer necessary. Tumor characterization using the ultrasound method will be based on the following elements: consistency, echogenicity, structure appearance, delineation from adjacent liver parenchyma, elasticity, posterior acoustic enhancement
  effect, the relation with neighboring organs or structures, vasculature
context_section_description: It is the most common liver tumor with a prevalence of 0.4 – 7.4%. It is generally
  asymptomatic but also can be associated with pain complaints or cytopenia and/or
  anemia when it is very bulky. It is unique or paucilocular. It can be associated with other
  types of benign liver tumors. Characteristic 2D ultrasound appearance is that of a very
  well defined lesion, with sizes of 2–3 cm or less, showing increased echogenity and, when
  located in contact with the diaphragm, a "mirror image" phenomenon can be seen. When
  palpating the liver with the transducer the hemangioma is compressible sending
  reverberations backwards. Doppler exploration reveals no circulatory signal due to very
  slow flow speed. CEUS investigation has real diagnosis value due to the typical behavior
  of progressive CA enhancement of the tumor from the periphery towards the center. The
  enhancement is slow, during several minutes, depending on the size of hemangioma and
  on the presence (or absence) of internal thrombosis. During late (sinusoidal) phase, if
  totally "filled" with CA, hemangioma appears isoechoic to the liver. Deviations from the
  above described behavior can occur in arterialized hemangiomas or those containing
  arterio-venous shunts. In these cases, differentiation from a malignant tumor is difficult
  and requires other imaging procedures, follow up and measurements of the tumor at
  short time intervals.
caption: Hepatic hemangioma (2D). The lesion is located in the left hepatic lobe. Note precise delineation, their increased echogenity and the heterogeneous internal structure.[citation needed]
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