Benign tumor composed of dilated vascular channels lined by single layer of endothelial cells and supported by thin, fibrous stroma

Typical hemangioma: Well-defined, uniformly hyperechoic mass

Internal vascularity often undetectable with color Doppler

May see posterior acoustic enhancement

“Typical atypical” hemangioma: Hyperechoic rim with hypoechoic center

Contrast-enhanced imaging

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  Arterial hyperenhancement: “Flash fill” homogeneous hypervascularity or nodular discontinuous hyperenhancement

  
  
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  Centripetal fill-in on later images

  
  
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  Enhancement follows blood pool

Focal steatosis

Hepatocellular carcinoma

Hypervascular metastases

Focal nodular hyperplasia

Hepatic adenoma

Large vascular channels lined by single layer of endothelial cells supported by thin, fibrous septa

Most common benign tumor of liver

Hemangiomas may change in echogenicity at different times of scanning due to rate of blood flow within lesion

To help improve visualization, try B-color ultrasound or 9-MHz linear transducer for more superficially located lesions