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Abdominal Hemangiomas: A Pictorial Review of Unusual, Atypical, and Rare Types  Vijayanadh Ojili, MD, Sree Harsha Tirumani, MD, Gowthaman Gunabushanam,

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Presentation on theme: "Abdominal Hemangiomas: A Pictorial Review of Unusual, Atypical, and Rare Types  Vijayanadh Ojili, MD, Sree Harsha Tirumani, MD, Gowthaman Gunabushanam,"— Presentation transcript:

1 Abdominal Hemangiomas: A Pictorial Review of Unusual, Atypical, and Rare Types 
Vijayanadh Ojili, MD, Sree Harsha Tirumani, MD, Gowthaman Gunabushanam, MD, Arpit Nagar, MD, Venkateswar Rao Surabhi, MD, Kedar N. Chintapalli, MD, John Ryan, MD, FRCPC  Canadian Association of Radiologists Journal  Volume 64, Issue 1, Pages (February 2013) DOI: /j.carj Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

2 Figure 1 Atypical sclerosing hepatic hemangioma. (A, B) Axial contrast computed tomography image of the liver in the portal venous phase, showing an irregular hypodense tumour (arrows), with heterogenous enhancement and central calcification. Biopsy of the lesion showed cavernous hemangioma. Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

3 Figure 2 Giant multiloculated hepatic hemangioma. (A-C) Axial postcontrast T1-weighted magnetic resonance images in arterial (A), venous (B), and 2-minute delayed (C) phases, showing large septated hypointense lesion (asterisks) with nodular (white arrows) enhancing septae. Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

4 Figure 3 Splenic hemangioma. (A) Ultrasound image of the spleen, showing a well-marginated hyperechoic tumour (asterisk). (B) Axial contrast computed tomography image, showing heterogenous enhancing lesion in the portal venous phase (asterisk). Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

5 Figure 4 Splenic hemangioma. (A, B) Axial dynamic contrast-enhanced T1-weighted magnetic resonance images in venous (A) and 5-minute delayed (B) phases, showing a hypointense splenic lesion with progressive centripetal filing (arrows). Note the incidental hepatic cysts (asterisks). Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

6 Figure 5 Gastric hemangioma in 2 different patients. (A, B) Axial contrast-enhanced computed tomography (CT) images in arterial (A) and venous (B) phase, showing circumferential thickening of body of the stomach (asterisks) with progressive enhancement. (C) Axial contrast-enhanced CT image of another patient in the venous phase, showing a large exophytic tumour with nodular enhancement arising from the gastric wall (asterisk). Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

7 Figure 6 Renal hemangioma in 2 different patients. (A, B) Axial contrast computed tomography (CT) images in arterial (A) and venous (B) phases, showing a peripheral nodular enhancing tumour (arrowheads) arising from the renal papilla. (C) Coronal reformatted CT image of another patient in late arterial phase, showing a large enhancing tumour with phleboliths (asterisk) filling the renal pelvis. Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

8 Figure 7 Perirenal hemangioma. (A, B) Axial contrast computed tomography (CT) images in the portal venous phase, demonstrating an enhancing tumour (asterisks), with phleboliths in relation to the upper pole of the right kidney. (C, D) Coronal and sagittal reformatted CT images, showing the tumour (asterisks) separate from the normal right adrenal gland (arrows). Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

9 Figure 8 Gastrosplenic ligament Hemangioma. (A, B) Axial contrast computed tomography in venous (A) and delayed (B) phases, showing a well-defined hypodense lesion (asterisks) in the gastrosplenic ligament with nodular enhancement. (C) Coronal true fast imaging with steady state precession magnetic resonance image (MRI), showing the tumour to be a T2 hyperintense tumour (asterisk). (D) Axial contrast-enhanced T1-weighted MRI in venous phase, showing nodular enhancement in the tumour (asterisk). Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

10 Figure 9 Retroperitoneal hemangioma. (A) Axial unenhanced computed tomography (CT) sections, showing a well-defined lesion (arrow) adjacent to the inferior vena cava. (B, C) Axial contrast-enhanced CT images in arterial and venous phases, showing peripheral enhancement and progressive central filling (arrows). Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

11 Figure 10 Psoas muscle hemangioma. (A) Axial non–fat-saturated T1-weighted magnetic resonance images (MRI), demonstrating a well-defined hyperintense lesion in the left psoas (arrow). (B) Axial T2-weighted MRI, showing the lesion to be hyperintense (arrow). Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

12 Figure 11 Hemangioma of the inferior vena cava (IVC). (A) Ultrasound image of intrahepatic IVC, showing a well-defined echogenic lesion in the wall (arrow). (B) Coronal reformatted contrast computed tomography image, showing the lesion as a filling defect in IVC with mild enhancement (arrow). (C, D) Axial T2-weighted and postcontrast T1-weighted magnetic resonance images, showing a hyperintense lesion with enhancement (arrows). Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

13 Figure 12 Hemangioma of abdominal wall. Axial computed tomography image in the arterial phase, showing serpiginous vascular channels (arrow) in the left lateral abdominal wall. Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

14 Figure 13 Inguinal canal hemangioma. Axial contrast-enhanced computed tomography sections of pelvis, showing enhancing irregular soft-tissue lesion (arrow) with phleboliths along the spermatic cord. Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

15 Figure 14 Klippel-Trénaunay syndrome. (A) Ultrasound image of the spleen, showing multiple hyperechoic lesions (white arrows) in the spleen, which represent hemangiomas. (B, C) Axial and (D) coronal reformatted contrast computed tomography images, showing hemangiomas in the liver (long white arrows), spleen (black arrow heads), left adrenal gland (black arrow), and right upper thigh (white arrow head). Thickened rectosigmoid with phleboliths (small white arrows) represents colorectal hemangiomatosis. (E) Axial true fast imaging with steady-state precession magnetic resonance images show T2 hyperintense hemangiomas in the liver (thick white arrows), left adrenal gland (thin white arrow), and spleen (black arrow heads). Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions

16 Figure 15 Giant hepatic hemangioma causing Kasabach-Meritt syndrome. (A, B) Axial contrast-enhanced computed tomography images in arterial and venous phases, showing a large nodular enhancing lesion (arrows), replacing almost the entire right lobe of liver. The patient developed consumptive coagulopathy. Canadian Association of Radiologists Journal  , 18-27DOI: ( /j.carj ) Copyright © 2013 Canadian Association of Radiologists Terms and Conditions


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