Case 4

This is an MRI liver study showing two focal liver lesions, one in the right lobe and one in segment IV. Both lesions are well defined, and show moderately high signal on the T2 weighted images. Within the larger lesion, there is a central area of higher T2 signal intensity, representing the ‘bright spot’. The lesions show low signal intensity on the T1 weighted images, and are bright on the DWI sequence with high ADC values. The post contrast sequences show peripheral nodular post gadolinium enhancement with progressive filling in of contrast so that more of the lesion is internally enhancing on the delayed images. The background liver shows normal parenchyma with no evidence of cirrhosis. These lesions are characteristic of cavernous haemangiomas.