Hepatic venous malformation (hemangioma)

Case contribution: Dr Radhiana Hassan


  • A 55 years old lady
  • Presented with right loin pain
  • Being investigated for urinary tract calculus and complex renal cyst
CT scan abdomen in axial plane soft tissue window

CT scan findings:

  • A large well-defined hypodense lesion is seen occupying right lobe of liver measuring approximately 5.4 x 5.5 x 8.3 cm (AP x W x CC).
  • No calcification of its wall.
  • This lesion demonstrate discontinuous, nodular, peripheral enhancement on arterial phase.
  • Progressive peripheral enhancement (centripetal fill-in) is seen on portovenous phase
  • More irregular fill-in on delay phase making the lesion relatively hyperdense compared to the rest of the liver parenchyma.

Diagnosis: Hepatic venous malformation (hemangioma)


  • Hepatic venous malformations also known as hepatic hemangiomas are the most common benign vascular lesion of the liver.
  • It is more common in female with F:M ratio up to 5:1.
  • It is considered congenital in origin.
  • Ultrasound typically shows well-defined hyperechoic lesions.
  • On CT scan, most hemangiomas are relatively well-defined. It is often hypodense on non-contrast study. On arterial phase it typically shows discontinuous, nodular, peripheral enhancement pattern, on portal venous phase it shows progressive peripheral enhancement with more centripetal fill-in. Delayed phase shows further irregular fill-in and therefore becomes iso or hyperdense compared to liver parenchyma.
  • Complications are rare include spontaneous rupture, abscess formation and Kasabach-Meritt syndrome.


  • Hepatic hemangioma at https://radiopaedia.org/articles/hepatic-haemangioma
  • Hepatic hemagioma; disorders of liver, biliary tract, pancreas and spleen. Wolfgang Dahnert.
Author: radhianahassan