Splenic Hemangiomas

Objectives The purpose of this study was to illustrate the baseline appearance and enhancement patterns of splenic hemangiomas on contrast‐enhanced sonography. Methods Two experienced radiologists retrospectively reviewed by consensus baseline and contrast‐enhanced sonographic examinations of 27 patients (14 women and 13 men; mean age, 58.7 years) with 27 splenic hemangiomas (mean size, 2 cm) confirmed by splenectomy, biopsy, computed tomography, and magnetic resonance imaging and follow‐up. Results On baseline sonography, 77.8% of the lesions showed a homogeneous echo texture that was mainly hyperechoic. Color Doppler imaging did not show any signal in 81.5% of the cases. After contrast agent injection, 59.2% of the splenic hemangiomas showed different degrees of contrast enhancement in the arterial phase followed by isoenhancement in the late parenchymal phase. Among these, 2 hemangiomas showed peripheral globular enhancement in the arterial phase, followed by progressive centripetal fill‐in. In 29.6% of the cases, some degree of contrast enhancement was appreciable, but the hemangiomas remained substantially hypoechoic throughout the contrast‐enhanced sonographic examinations, whereas in 11.1%, the combination of contrast enhancement in the arterial phase followed by wash‐out in the late parenchymal phase was evident. Conclusions Isoechogenicity to spleen parenchyma in all phases is the most frequent typical enhancement pattern of splenic hemangiomas observed on contrast‐enhanced sonography. Nevertheless, these lesions may show atypical contrast enhancement patterns; therefore, further assessment with cross‐sectional techniques is needed.