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Probable Liver Hemangioma

I had a CT scan a few weeks ago for something unrelated to my liver. I read through the CT report and it said I have a probable liver hemangioma, and it suggested I have a followup CT scan to make sure it is a hemangioma and not a cancerous tumor.

My question is this: is an MRI as accurate as a CT scan in determining if the spot on my liver is a hemangioma and not cancerous? Other than cost, is there a reason I should have a CT scan instead of an MRI? I would rather not have the radiation exposure of a CT scan if an MRI will produce adequate data.

Thank you!
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682969 tn?1249004605
My story might help you.  It is a bit long but this is the only way I can tell it. If I could do it over, I would demand an MRI first. From my research on the net, I think it says a MRI is more accurate. I feel the need to share my story in case it can give some insight.

In February 2008, I had to get a physical in order to have outpatient foot surgery for plantar fasciitus. Primary care doc sent me to urologist for slight blood in urine. Urologist sent me for cat scan of my bladder and kidneys to check for bladder cancer because I used to smoke. Even though I had quit 14 years ago. Cat scan for that fine (slight blood normal for me because of few extra red blood cells).But radiologist noticed a barely visible nodule or lesion in my liver. Was told will check in 6 months-probably nothing. Well in Sept 2008 liver cat scan showed 3 or 4 lesions in right lobe all less than 2 cm. Doctor had me get a neck to pelvis scan same day. Results came in. Everything fine except for liver lesions. Came back indeterminate and worrisome for metastatic cancer. Was told to get biopsy. Went home and did research on internet. Thought they might be hemangiomas and was worried about biopsy because I read that biopsy of hemangioma could be dangerous for bleeding. Left printed article and wrote down concerns and gave to doctor's receptionist. Nurse called me next day and said lesions did not look like hemangiomas and to get biopsy. Got really scared about cancer because tests were being rushed. Biopsy done on largest lesion. I asked radiologist about hemangiomas and he said if he thought if they looked like that he would not do biopsy because of bleeding risks. Well, biopsy came back hemangioma! Doctor said wow what you said! He sent me to a gastroenterologist to check out other lesions. That doc sent me for an MRI. MRI came back 6 or 7 lesions in both lobes and did not jive with hemangiomas. Still worrisome for cancer. Then I passed a colonoscopy, endoscopy, and blood work up of the liver. I had had a mammogram and pap smear March 2008 and everything okay. Was told I needed a second biopsy because doc was afraid maybe radiologist did not get a good sample during first biopsy. Maybe he just got some blood off the top of lesion. Meanwhile I was taken off of prempro for menopause because oestrogens and birth control pills are believed to make liver tumours grow larger which is dangerous. I have lost 50 lbs since March because I gave up diet soda and started eating healthy. I only drink water. But my liver doc thought my weight loss was a sympton of cancer, I had to assure him that was not the case. I have worked too hard to let him think that. He still thought that was too much weight loss. In the meantime I was feeling great with no symptoms whatsoever. This couldn't be happening to me! The doc told me the fact that my lesions or tumours were multiple was why he was worried about cancer. He said my case was unusual. He said if cancer was metastatic (which means cancer has spread to the liver from somewhere else in the body) I would need chemotherapy. If I had primary liver cancer I would need a transplant because the tumours were in both lobes. Well 6 weeks of worry can take its toll emotionally. Thank God for prayer, family and friends. The research I did online scared me and helped me at the same time. I discovered that hemangiomas are probably present since birth. 20 percent of people have multiple hemangiomas. Some hemangiomas are atypical in shape. Some are considered giant if they are over 5 cm. Those sometimes have to be resected with surgery because they cause pain. Rarely they can rupture when they are giant and that is life threatening. Sometimes  a diagnosis is difficult because sometimes cat scans and MRIs can't differientiate because lesions are too small to characterize like in my case. That is called indeterminate. A biopsy (pathological testing) is the only way to tell. The actual tissue must be analyzed to determine if cancer or hemangioma in a case like mine.

Second biopsy was done on October 17, 2008. Very different from first one. The radiologist came in and told me he didn't think I should even be getting a second biopsy because he could tell by reviewing all 3 cat scans, MRI, and first biopsy, that what I had was clearly hemangiomas. I told him liver doc wanted him to biopsy 2 lesions and to make sure he didn't biopsy same lesion from first biopsy. He said no way would he do more than one lesion.  There was enough risk doing one because of the chance of bleeding and needing transfusion. ( according to research risks are not as high as once thought).  After radiologist got sample he showed it to me in my face and told me it was indeed nothing but a hemangioma. Ultrasound guy agreed and said all my lesions he could see looked  like that too. Boy was I relieved!  I can deal with hemangiomas better than cancer! I know you are not usually told details like that during testing. I think the radiologist felt my need to know. He also told me to take it easy for a few days and if I felt any of the symptoms on my checklist to call 911 right away. He said to grab the receptionist by the shirt and demand a liver cat scan immediately. Wow! He was serious too. But I was fine.  I had to lay on my right side for four hours at the hospital and then I got to go home. The only discomfort I had was residual rigth shoulder pain that was relieved with a pain pill.

October 31, 2008 I had a consultation with liver doc to discuss biopsy results. He said that he felt like my lesions were indeed hemangiomas. He consulted with several radiologists and they all agreed with that diagnosis. He even said that one radiologist said that he looked at the original kidney and bladder scan from February, 2008 and could see all 7 lesions. And there was no change in size or quantity! I was shocked! I guess it depends on who reads the tests. It was probably the doc that did my second biopsy! In 6 months they thougtht one became 3 or 4 lesions in right lobe. A month after that they thought 6 or 7 lesions in both lobes. They were thinking cancer the whole time. They checked everything but my brain. Unbelieveable going through that stress and all those tests for two months!

I am grateful that my liver doctor was determined to find out what I have. I must say it is nice to know that I am very healthy and only need to have periodic monitoring of my seven liver hemangiomas. I demanded a MRI for the followup instead of a cat scan. in three months.

Because the MRI showed all seven lesions. I had three cat scans and they all didn't show up. I feel it is better to spend the money on the MRI because 3 cat scans probably add up to more than one MRI.  Even though the MRI didn't come back hemangiomas, it still showed all 7 lesions. I think mine were atypical in shape and had some fibrous tissue in them and were too small to characterize. Which is why the biopsy was needed. Also I forget which is which but lesions are either heterogenous or homeogenous. One looks like cancer and one does not. And some are just atypical and hard to diagnose whether it's cancer or not. Sorry for such a long reply, but if I can share my story and it helps someone, then I am grateful. I wish the best for you.
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Avatar universal
Hi! If they don't think it's an atypical hemangioma, you could ask for an ultrasound to be performed. I'm a sonographer & we can see these quite well. If it has the classic sonographic appearance for a hemagioma, you should not need any further testing. Most radiologists prefer not to stick needles in hemagiomas. Another test that can be done, especially in cases where they're atypical in appearance is a tagged red blood cell scan, which is performed in the Nuclear Medicine Dept. Often times, it can answer the question with certainty.
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Avatar universal
I have the same thing - i have 5 hemangiomas that were diagnosed with an ultra sound. i wonder if i need to do an autopsy or other test - the ultrasound said it was typical of hemangioma....
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