Journal of Ultrasound in Medicine, Vol 9, Issue 11 619-624, Copyright © 1990 by American Institute of Ultrasound in Medicine
Sonographic and Doppler features of infantile hepatic hemangiomas with pathologic correlation
M. A. Klein, T. L. Slovis, C. H. Chang and I. G. Jacobs
Department of Radiology, Wayne State University School of Medicine/Detroit Medical Center, Michigan.
The sonograms of five patients with a diagnosis of infantile hepatic
hemangioma were retrospectively reviewed to analyze their sonographic and
Doppler characteristics. Three patients had single lesions, whereas two had
multifocal involvement. All lesions except one were hypoechoic,
well-circumscribed, and solid; the exception was hyperechoic. Findings of
high flow, ie, large draining veins, an abrupt change in aortic caliber,
and the presence of Doppler signal throughout the lesion were seen in three
of five patients. The sonographic findings correlate well with the
pathologic findings of multiple vascular channels separated by fibrous
septa. The major differential diagnosis of infantile hepatic hemangioma
includes hepatoblastoma and metastatic neuroblastoma. Although some of
their sonographic features may simulate a hemangioma, large draining veins
and changes in aortic caliber are not reportedly seen. Doppler flow was not
seen in either of these malignant neoplasms in our study and, to date, has
only been reported peripheral to three cases of hepatoblastoma and not at
all in metastatic neuroblastoma. We propose an algorithmic approach
dependent upon the sonographic-Doppler appearance.
