What is contrast-enhanced ultrasound of hepatic hemangioma like?
Nov 06, 2025
Source: Cainiu Health
Dr. Liu Feng
Introduction
The contrast-enhanced ultrasound features of hepatic hemangiomas generally include peripheral enhancement in the arterial phase, progressive filling in the portal venous phase, homogeneous enhancement in the delayed phase, well-defined margins, and absence of a capsule. After contrast agent injection, during the arterial phase, the periphery of the hemangioma shows nodular, ring-like, or punctate enhancement with intensity similar to that of the hepatic artery. This occurs because the peripheral vessels of the lesion rapidly receive the contrast agent first, representing a typical early-phase finding.
Ultrasound contrast imaging findings of hepatic hemangiomas generally include peripheral enhancement in the arterial phase, progressive centripetal filling in the portal venous phase, homogeneous enhancement in the delayed phase, well-defined margins, and absence of a capsule. Detailed analysis is as follows:
1. Peripheral enhancement in the arterial phase: After administration of contrast agent, nodular, ring-like, or punctate enhancement appears at the periphery of the hepatic hemangioma during the arterial phase. The intensity of enhancement is similar to that of the hepatic artery. This occurs because the peripheral vessels of the lesion receive the contrast agent first, representing a typical early-phase finding.
2. Progressive filling in the portal venous phase: Over time, during the portal venous phase, the contrast agent gradually fills the lesion from the periphery toward the center. This filling process is slow and continuous, with the enhanced area progressively expanding and the contrast difference between the lesion and surrounding liver tissue gradually decreasing.
3. Homogeneous enhancement in the delayed phase: In the delayed phase, the contrast agent has largely filled the entire lesion, resulting in uniform enhancement. The enhancement intensity is close to or slightly higher than that of normal liver parenchyma, with no obvious filling defects. This represents a characteristic late-phase appearance of hepatic hemangiomas on contrast-enhanced ultrasound.
4. Well-defined boundaries: Throughout the contrast imaging process, the boundary between the hepatic hemangioma and the surrounding normal liver tissue remains clearly demarcated, without evidence of blurred infiltration. This allows precise delineation of the lesion's size and extent, providing clear diagnostic basis.
5. Absence of capsule: On contrast-enhanced ultrasound, hepatic hemangiomas show no visible capsule. The transition between the enhanced area and normal liver tissue is smooth and natural, without ring-like capsular enhancement, helping differentiate hemangiomas from other liver tumors that may have a capsule.
Contrast-enhanced ultrasound is an important method for diagnosing hepatic hemangiomas, and typical imaging features can establish a definitive diagnosis. In atypical cases, further evaluation with CT or MRI may be required for differential diagnosis.
