Purpose: To define the appearance of hepatic hemangiomas on T2-weighted and serial gadolinium-enhanced gradient-echo magnetic resonance (MR) images.
Materials and methods: In four university hospitals, with 1.0- or 1.5-T MR imaging, T2-weighted and T1-weighted gradient-echo images were obtained in 66 adult patients before and at 1, 45, and 90 seconds and 10 minutes after injection of a gadolinium chelate. Hemangiomas were categorized as small (< 1.5-cm-diameter), medium (1.5-5.0-cm), and large (> 5.0-cm) tumors.
Results: In all, 154 hemangiomas were depicted (81 small, 56 medium, and 17 large tumors). All 154 lesions were hyperintense on T2-weighted images. Three patterns of contrast enhancement were observed: (a) uniform enhancement at 1 second (35 of 81 small lesions and no medium or large lesions), (b) peripheral nodular enhancement progressing centripetally to uniform enhancement (75 of all 154 lesions), and (c) peripheral nodular enhancement with persistent hypointensity centrally (44 of all 154 lesions, including 16 of 17 large lesions).
Conclusion: Three patterns of enhancement of hemangiomas were observed. High signal intensity on T2-weighted images provided complementary information.