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Hemangioma of the liver

Technical: Contrast agent: Sonovue, Bracco Inc.

Presentation: The patient is a 53 y.o male smoker with findings of suspicious opacity on a chest plain film.

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Caption: CT scan
Description: Unenhanced CT scan found a 20 mm nodule in the segment IV of the liver

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Caption: Transverse scan of liver
Description: Ultrasound of the lesion demonstrated on CT shows a predominately hyperechoic mass with mixed echogenicity, edge shadows and no significant posterior enhancement.

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Caption: Baseline prior to injection of ultrasound contrast agent
Description: The lesion appears slightly hyperechoic at baseline US

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Caption: Post injection 1
Description: After contrast agent injection there is peripheral globular enhancement and centripetal filling-in of the lesion,

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Caption: Post injection 2
Description: There is a continuation of peripheral globular enhancement and centripetal filling-in of the lesion with no wash-out. 

Caption: Video clip
Description: After Sonovue injection, we observe peripheral globular enhancement and centripetal filling-in of  the lesion with no wash-out. This enhancement pattern is characteristic of Hemangioma.


Discussion: The lesion appears slightly hyperechoic at baseline ultrasound. After contrast agent injection, we observe peripheral globular enhancement and centripetal filling-in of the lesion with no wash-out. This enhancement pattern is characteristic of Hemangioma.

Differential: After CT and US: Metastasis, hemangioma, HCC, cholangiocarcinoma, adenoma    

Final: Hemangioma of the liver