American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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Prepare for the ABS QE with flashcards and multiple-choice questions. Each question provides hints and explanations to enhance understanding. Start your journey to becoming a certified surgeon and tackle your exam with confidence!

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Which of the following findings is typical for hemangiomas in liver imaging?

Centripetal filling
No enhancement
Prolonged enhancement
Rapid washout

The correct answer is: Centripetal filling

In liver imaging, hemangiomas are known to present with a characteristic pattern referred to as centripetal filling. This phenomenon occurs because, during the contrast-enhanced imaging process, hemangiomas gradually demonstrate enhancement from the periphery towards the center over time. Initially, the periphery of the hemangioma becomes enhanced as the contrast medium accumulates, and as it continues to fill, there is a noticeable increase in the enhancement of the central areas. This pattern is especially observable on MRI with contrast when evaluating hemangiomas. Due to the vascular nature of these lesions, they have a unique blood supply that allows for this centripetal filling effect, which is a key feature that differentiates them from other liver lesions. In contrast, other imaging findings such as prolonged enhancement or rapid washout are typically associated with different types of liver lesions, like focal nodular hyperplasia or hepatocellular carcinoma, which do not display the same progression of enhancement seen in hemangiomas. Additionally, the lack of enhancement in liver hemangiomas is not characteristic; they are notably vascular and show enhancement upon contrast administration.