Liver hemangioma: US-guided 18-gauge core-needle biopsy.

PURPOSE: To assess the clinical usefulness of ultrasound (US)-guided, 18-gauge core-needle biopsy of liver hemangiomas performed with a one-hand automatic-sampling technique.

MATERIALS AND METHODS: In 491 US-guided core-needle biopsies of the liver, hemangioma was suspected at US in 51 cases. Hemangiomas were confirmed histologically in 29 cases, a malignant lesion was revealed in six cases, and no specific diagnosis could be made in 16 cases. Hemangioma was diagnosed in 18 lesions that appeared malignant at US. The hemangiomas were 7-114 mm in diameter (mean, 45 mm).

RESULTS: The histologic diagnosis of hemangioma was unequivocal in 47 biopsy specimens. A cuff of normal hepatic parenchyma could be interposed between the capsule and the margin of the hemangioma in all procedures but one, in which two direct punctures were made of a protruding giant hemangioma. An average of 1.4 punctures were performed at each biopsy session. There were no false-positive findings and 15 or perhaps 16 false-negative findings. There were no serious complications.

CONCLUSION: US-guided core needle biopsy seems to be a safe procedure when the diagnosis of hemangioma must be ascertained. Conclusive biopsy findings may shorten the diagnostic work-up, benefiting the patient and the hospital.