30 year old gentleman went for a routine health check up as a part of his job health clearance and was detected to have a heteroechoic focal lesion in right lobe of liver. A multiphase contrast enhanced CT study was requested to identify the nature of the lesion.
Triphasic CT
Arterial phase
Portal phase
Delayed phase
Summary image
Findings
Intense filling up of the lesion with contrast similar to density in abdominal aorta, that remains homogeneous to vascular pool in portal and delayed venous phases. This is a finding classically described in benign flash filling hemangiomas.
Discussion
Flash filling hemangiomas are rightly called so due to the rapid nature in which i.v administered contrast pools up as early as the angiographic and arterial phase of imaging. The fact that the contrast persists and synchronizes with the density in the vascular compartment identifies this benign tuft of vessels as a venous malformation of no clinical significance. High sensitivity and specificity of CT diagnosis obviates requirement of any further imaging. A note of caution should be addressed to the patient to keep hold of his medical record and to notify physicians and radiologists to obviate any invasive diagnostic later on.
Read more