Thoracic hemangiomas - Imaging via CT, MR, and PET along with pathologic correlation

Purpose: To characterize the imaging features of thoracic hemangioma, including findings on computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) using F-18-fluoro-2-deoxy-D-glucose (FDG). Methods: Six patients with thoracic wall hemangioma and 2 patients with mediastinal hemangioma were included in this study. Preoperative evaluation was performed using CT (n = 7), MRI (n = 8), and FDG-PET (n = 2). Five cases were pathologically confirmed by surgery and the remaining 3 cases were diagnosed clinically. Results: On CT, characteristic finding of phleboliths were depicted in 5 of 7 cases (71%). Fat component was demonstrated in 3 of 7 cases with CT (3/7-43%) and 5 of 8 cases with MRI (5/8-63%). On MRI, characteristic finding of high intensity on T2-weighted images was demonstrated in all 8 cases and the high signal intensity was emphasized in all 4 cases on fat-suppression T2-weighted images. Both of two PET scans showed mildly elevated accumulation of FDG. Conclusions: Phleboliths, fat component, and high intensity on T2-weighted and fat-suppression T2-weighted image were thought to be characteristic findings reflecting the histologic findings. It might be useful to recognize these findings for differentiating hemangiomas from other soft tissue tumors, particularly malignant neoplasms.