Objective: The purpose of this study was to summarize and illustrate the sonographic appearance of hepatic hemangiomas with arterioportal shunt and to correlate them with CT and MRI findings.
Conclusion: High-flow hepatic hemangiomas tend to be seen as hypoechoic lesions at sonography. In the presence of fatty infiltration in the liver, they may accompany peritumoral low-echoic areas presumably caused by peritumoral sparing of fatty infiltration similar to a hyperattenuating or hyperintense peritumoral rim on unenhanced CT or MR chemical shift imaging. Color Doppler sonography may reveal intratumoral flows, large feeding arteries, and reversal of portal flow around the tumor. Knowledge of such sonographic findings may ensure an accurate sonographic diagnosis of these tumors.