Hemangiomas on Ultrasound but Not On CT

[KaratW]

My husband was having chest pain & fatigue - the Doctor did a treadmill stress test/EKG (results normal, no blockage of arteries).  He then ordered an abdominal ultrasound (to rule out gallbladder problems that could be referring pain to the chest).  The gallbladder was normal but 3 hemangiomas were seen on the liver.  I don't have the report but it said something about having 2 cavernous hemangiomas (about 1cm in size) and a 3rd (3cm) that was probably also a hemangioma but would suggest chest/abdominal CT to verify that's what it/they were.  So he then had the CT scan and his Doctor told him the results were "negative" - again something about "no evidence to support the ultrasound findings".  His doctor told him just to follow up with him in 3 months (as if nothing were really wrong).  I'm wondering - is it possible for liver hemangiomas to show up on ultrasound, but not on CT?  Does this mean they didn't show up at all on the CT??  We still don't know what is causing his chest pressure, and I'm not comfortable waiting 3 months to go back to the Doctor - seems like he's just waiting to see if something else, or worse, happens.....

[Kevin Pho, MD]

Studies show that ultrasound is about 80 percent accurate in detecting hemangiomas.  CT may be a more accurate modality in this case.  I would suggest that if the hemangioma isn't seen by CT, then it probably isn't there.  

MRI is emerging as the most accurate study and you may want to consider this if you have any doubt.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.