Lobulated margination of liver hemangiomas: Is this a definitive feature?

PurposeTo evaluate the occurrence rate of lobulated margination of hepatic hemangiomas.MethodsThe study population included 585 hemangiomas in 261 patients (161 females; mean age: 51.9 years). Two readers independently reviewed all cases.ResultsHemangiomas with lobulated margins accounted for 74.7% of all lesions. The incidence of lobulated margins was significantly higher (P < .001) in medium- and large-sized hemangiomas (77.6% and 99.5%, respectively). The majority of hemangiomas with type-3 enhancement showed lobulated margins (83.5%) (P < .001).ConclusionVirtually, all hemangiomas > 18 mm show lobulated margins. The majority of hemangiomas with type-3 enhancement show lobulated margins. Lack of lobulated margins in larger lesions lowers the likelihood ratio for being hemangiomas.