A case of capillary hemangioma of the liver examined by contrast-enhanced ultrasonography with perfluorobutane (Sonazoid^®)

Abstract

The patient was a 65-year-old man. Contrast-enhanced computed tomography for screening revealed hypervascular tumor measuring 28 mm in diameter in the liver. On ultrasonography, the tumor was hypo-echoic and heterogeneous. On contrast-enhanced ultrasonography (CEUS) with perfluorobutane (Sonazoid^®), the tumor was strongly enhanced rapidly and appeared homogeneous in the arterial predominant phase. In the portal predominant phase, it was still enhanced. In the post vascular phase, it became iso-echoic in comparison with the liver's background. As the possibility of malignant tumor could not be ruled out, needle biopsy was performed and the histopathological diagnosis was capillary hemangioma. Because capillary hemangioma lacks large, cavernous vascular space, it has rapid internal flow and fills rapidly. Consequently, it is enhanced in the arterial predominant phase rapidly, and remains enhanced in the portal predominant phase. In this case, CEUS with Sonazoid^® revealed characteristic findings for capillary hemangioma.