12:53 CET
RC 101 - Imaging of benign liver lesions: still difficult?
Abdominal Viscera Education
Wednesday, February 27, 08:30 - 10:00
Type of session: Refresher Course
Topic: Abdominal Viscera, Education
Moderator: P. Ricci (Rome/IT)

Chairperson's introduction
P. Ricci; Rome/IT
Learning Objectives

1. To understand the role of different imaging techniques in the characterisation of focal liver lesions.
2. To be aware of malignant lesions which may mimic benign liver conditions.
3. To underline current guidelines for the characterisation of equivocal liver lesions.

A. Hepatic cysts: always simple?
I. Santiago; Lisbon/PT
Learning Objectives

1. To learn about different types of cystic lesions in the liver, including giant biliary hamartomas or foregut cysts.
2. To understand the diagnostic approach to differentiate simple and complex cysts/cystic lesions.
3. To appreciate advantages and limitations of imaging for differentiating simple cysts from other cystic lesions.


The differential diagnosis of cystic liver lesions is as broad as their clinical significance, which ranges from benign to malignant and/or potentially lethal conditions. These lesions include foregut and ductal plate malformations, infectious conditions, primary and secondary neoplasms and traumatic/iatrogenic fluid collections. The number of lesions, morphology, fluid content characteristics, presence/absence of septae and/or solid components are the key imaging features for the diagnostic approach, and different imaging modalities pose different advantages and disadvantages for their characterisation. Given imaging characteristics may overlap between distinct conditions, patient history and laboratory data should be integrated to allow a more definitive diagnosis.

B. Liver haemangiomas and mimickers
F. Caseiro Alves; Coimbra/PT
Learning Objectives

1. To learn about typical imaging findings of liver haemangioma.
2. To understand the atypical imaging findings of liver haemangiomas.
3. To appreciate the role of multiparametric and liver-specific contrast MRI in differentiation between haemangiomas and malignant lesions mimicking haemangiomas.


Haemangiomas are common focal liver lesions, generally detected in the work-up of asymptomatic patients and do not require further workup, follow-up, or treatment. From the morphologic point of view, they can be classified as small (capillary) or large, with cavernous vascular spaces that may prone to show thrombosis, calcifications and hyalinisation. The polymorphic imaging appearance of haemangiomas depends on their histological features and flow pattern. The widespread use of cross-sectional imaging has allowed a better characterisation of this benign vascular tumour and for this lecture illustrative cases will be displayed
especially using CT and multiparametric MRI including hepato-biliary contrast
agents. Haemangiomas imaging findings may range from the commonly known aspects especially after extra-cellular Gd-chelates administration to atypical patterns where its recognition and positive diagnosis may not be so straightforward. The scope of the present lecture to present and discuss the patterns of those vascular liver lesions, describing normal findings, pitfalls, potential differentials, confounders and complications.

C. FNH or adenoma?
A. Ba-Ssalamah; Vienna/AT
Learning Objectives

1. To learn the imaging features associated with FNH and adenoma on contrast-enhanced CT and MRI.
2. To understand how the imaging characteristics are related to the underlying pathological findings.
3. To appreciate the optimal use of liver-specific contrast media for distinguishing between FNH and adenoma, and current classification and pathological characteristics and its impact on the management.

Panel discussion: What imaging strategy for my routine clinical practice?
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