title: Association of hepatic hemangiomatosis with giant cavernous hemangioma in the adult population: prevalence, imaging appearance, and relevance.
abstract: OBJECTIVE
  The purpose of our study was to evaluate the association of hepatic hemangiomatosis with giant cavernous hemangioma (GCH) and describe the imaging appearances and clinical relevance.
  
  
  METHODS
  Forty-one patients who had undergone CT or MRI with reported GCH (> 8 cm) between 1997 and 2009 were identified retrospectively. Three readers interpreted 27 MRI studies, 36 CT studies, and 16 ultrasound studies of these patients. Prevalence, extent, and imaging appearance of coexistent hemangiomatosis in the surrounding liver parenchyma were evaluated.
  
  
  RESULTS
  Forty-two GCHs were identified in 41 patients and hemangiomatosis was present in 18 of 41 patients (44%) with GCH. Twelve patients had a diffuse pattern of hemangiomatosis (67%), and six patients showed a nodular pattern consisting of multiple coalescent nodules measuring < 5 mm (33%). There was no association between the size of the GCH and presence and extent of hemangiomatosis. The common hepatic artery was enlarged (> 5 mm) in 14 patients with GCH, of whom 12 had associated hemangiomatosis. There was a statistically significant association between the size of the hepatic artery and presence of hemangiomatosis (p < 0.001).
  
  
  CONCLUSIONS
  Hemangiomatosis is not rare in the liver parenchyma adjacent to a GCH. The presence and extent of hemangiomatosis must be specifically communicated to referring physicians. Surgical candidates have to be carefully selected to avoid complications, such as excessive blood loss and diminished risk of postoperative liver decompensation from apparent overestimation of functional residual volume due to oversight of involved liver areas by hemangiomatosis.
authors.affiliation: Department of Medical Imaging, University of Toronto, University Health Network and Mount Sinai Hospital, 610 University Ave, 3-957, Toronto, ON M5G2M9, Canada. kartik.jhaveri@uhn.on.ca
authors.forename: Kartik S
authors.initials: KS
authors.lastname: Jhaveri
authors.forename: Paraskevi A
authors.initials: PA
authors.lastname: Vlachou
authors.forename: Maha
authors.initials: M
authors.lastname: Guindi
authors.forename: Sandra
authors.initials: S
authors.lastname: Fischer
authors.forename: Korosh
authors.initials: K
authors.lastname: Khalili
authors.forename: Sean P
authors.initials: SP
authors.lastname: Cleary
authors.forename: Anoop P
authors.initials: AP
authors.lastname: Ayyappan
mesh_terms: D000328:Adult; D000798:Angiomatosis / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006392:Hemangioma, Cavernous / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008107:Liver Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C064925:gadodiamide; C044834:iodixanol; D019786:Gadolinium DTPA