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Hepatic Cavernous Hemangioma in Cirrhotic Liver
from: Korean J Radiol 2000 ; 1 : 185-190 All authors: Department of Diagnostic Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine.Cavernous hemangioma is the most common benign hepatic tumor. Various imaging techniques all show that the condition usually presents with fairly distinctive findings, but there can also be signs of a lesion with a typical findings that must be distinguished from one that is malignant (1 6). Most hemangiomas do not change in size or appearance during follow-up studies (7 9), though some investigators have suggested that cavernous hemangiomas degenerate and be- come smaller or vanish during the process of liver cirrhosis (9 11). To our knowledge, no report has described the imaging findings in cavernous hemangiomas detected in cirrhotic liver. Because of the difficulty of distinguishing between hepatocellular carcinomas and hepatic cavernous hemangiomas in this circumstance, a description of the imaging findings of hepatic cavernous hemangioma during the changes occurring in liver cirrhosis is needed. In this report, we describe the imaging findings of hepatic cavernous hemangiomas obtained during various imaging studies of cirrhotic liver.
This study suffers from several limitations. Case selection, for example, depended solely on imaging findings, without pathologic confirmation. On the basis of a statement made by Nelson and Chezmar, two or more confirmatory study results were combined and used as a diagnostic gold standard for each lesion. With regard to the US findings which were entirely subjective, the hard copies concerned, with retrospective review, were not useful for lesion-to-lesion analysis in this study. During follow-up however, when it was known that hemangiomas were pre- sent, the majority of small ones could not be delineated from the coarse background of cirrhotic liver. Finally, long- term follow-up data for cirrhotic change was not available for the majority of patients, and in no case was cirrhosis-related change in a hepatic cavernous hemangioma clearly demonstrated.
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