The diagnosis is firstly made with USG and then supported with contrast enhaced CT.

The hemangiomas were well-defined hypoechoic lesions on sonography. In one case of diffuse hemangiomatous involvement of the liver, sonography showed the liver to be enlarged and heterogeneous in echo textures. Calcifications and widening of blood vessels were also seen on sonography. Common hepatic artery, celiac trunk, intermediate hepatic vein and aorta in retrocrural space were dilatated.

Characteristic CT features for the diagnosis of IHH consist in: peripheral contrast enhancement of the tumor in the arterial phase and the progression of the contrast enhancement towards the center at a later stage; a reduction in the aortic caliber (mid-aortic syndrome) distal to the level of the celiac axis because of the important vascular distribution toward the liver which will also cause celiac trunk and hepatic artery hypertrophy [5].

CT findings are dependent on the timing of the scan related to the administration of contrast medium. Before contrast enhacement, most lesions were hypodense compared with the liver, well defined- heterogeneous with nodular and "ring"- like calcifications-, or multifocal- spherical and homogeneous in their density, diffuse distributed. They enhanced in a centripetal fashion, with the periphery of a lesion enhancing first. If the scan was delayed, the entire lesion generally enhanced uniformly and intense [6]. Focal lesions were more heterogeneous in their appearance with large hepatic arteries and hepatic veins and variable enhancement, usually centripetal but often sparing the center of the lesion. CT studies showed evidence of high flow with dilatation of the proximal abdominal aorta, hepatic arteries, and hepatic veins and reduced size of the abdominal aorta distal to the level of the celiac axis (mid-aortic syndrome due to vascular steal phenomenon). The lesion was drained by intermediate hepatic vein which appeared hypertrophic with arterialization (vascular shunt). Some focal hemangiomas contained calcification.