'Variable echo sign' (ultrasonographical alteration of echogenicity) in cavernous hepatic hemangioma

There are few reports describing cavernous hepatic hemangiomas with alterat ion of ultrasonographical imaging during examinations. We performed ultraso nographic examination of 64 cavernous hepatic hemangiomas and recognized 26 cases (41%) with an alteration of echogenicity during the examinations. We refer to this alteration of echogenicity of cavernous hepatic hemanigoma a s a 'variable echo sign'. We performed angiography of the cavernous hepatic hamangiomas with variable echo sign. Most of these imaging patterns showed mild or moderate pooling, suggesting that the alteration of echogenicity m ight be based on a slow blood flow exchange. We suggest that a variable ech o sign is specific to ultrasonographic imaging with cavernous hepatic heman gioma and may be useful to differentiate cavernous hepatic hemangioma from other tumors.