Noninvasive diagnosis of small cavernous hemangioma of the liver: advantage of MRI.

Thirty-three lesions of small cavernous hemangioma of the liver under 3 cm in diameter detected by sonography, computed tomography (CT), or magnetic resonance imaging (MRI) were reviewed. Sonography detected 23 lesions, plain CT 15 out of 26, and MR 31, including one equivocal. On sonography, 18 of 23 revealed a strong, almost homogeneous hyperechoic mass without a rim. On CT, eight of 33 showed characteristic findings of hemangioma by contrast enhancement. On MRI, 26 of 31 appeared as a markedly high-intensity area, which was rarely the appearance of other hepatic tumors of similar size. Spin-spin relaxation time (T2) of hemangioma was prolonged over 80 msec in 15 of 18 while one of 20 lesions in patients with primary or secondary liver cancers under 3 cm showed T2 of 80 msec or more. MRI in addition to sonography and/or CT allowed detection of almost all cavernous hemangiomas over 1 cm in diameter and diagnosis with considerably high accuracy and specificity. MRI will play an important role in determination of necessity of further invasive diagnostic methods for patients with small liver tumors detected by sonography and/or CT.