What imaging modality is the diagnosis of choice for liver hemangioma?

The diagnosis of choice for a liver hemangioma is MRI due to its superior ability to characterize soft tissue and vascular lesions without the use of ionizing radiation. MRI provides excellent contrast resolution, allowing for the identification of the typical features of a hemangioma, such as its classic "honeycomb" appearance and enhancement patterns after the administration of contrast agents.

In particular, hemangiomas usually exhibit high signal intensity on T2-weighted images and show progressive contrast enhancement on the dynamic images, making MRI an ideal tool for accurately diagnosing and differentiating hemangiomas from other liver lesions, such as focal nodular hyperplasia or hepatocellular carcinoma.

While CT scans can also be used and are often employed, they typically do not provide the same level of detail in soft tissue differentiation as MRI. Ultrasound can be useful for initial evaluation and is often used as a first-line imaging modality, but it may not always adequately characterize liver hemangiomas. X-rays are not effective for this purpose, as they cannot provide the necessary detail of the liver's soft tissue structures or vascularity.