GI Radiography


Case 9 :
 

A 12-day-old female child presents with hepatomegaly and congestive cardiac failure.
Diagnosis was suggested on USG. An MRI was performed for further evaluation.
What is the diagnosis?

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Imaging Findings
Axial T1WI revealed marked hepatomegaly with distortion of the hepatic and portal radicles. On T2WI, multiple, oval and rounded hyper intense lesions were seen involving almost the entire liver. These lesions were surrounded by hypo intense capsule. Signal-void areas representing feeder vessels were seen in some of these lesions. Celiac artery was dilated. All these findings were suggestive of hepatic hemangiomas. Cutaneous hemangioma is also noted in the back.
The child expired within 3 weeks of birth. Post-mortem findings confirmed the diagnosis.

 

Brief Discussion
Hemangiomas are usually much smaller in size and are detected incidentally on USG examination. However, when large, they can produce cardiac failure due to arterio-venous shunting. Other smaller groups of patients can present with thrombocytopenia.

Contribution
Dr. Deepak Patkar, MRI Nanavati Hospital, Mumbai.