EURORAD ESR

Case 437

Focal nodular hyperplasia of the liver with atypical CT and MR imaging features: diagnosis by contrast-enhanced harmonic power Doppler ultrasound

Author(s)
D. Cioni, R. Lencioni, C. Bartolozzi
 
Patient
female, 38 year(s)
 
 
  • Figure 1
    Focal nodular hyperplasia of the liver
     

    The lesion is located in the II hepatic segment and is isoattenuating to normal liver parenchyma (ie, not detected) in the unenhanced spiral CT image

     
    Area of Interest: unknown; Imaging Technique: Focal nodular hyperplasia of the liver;

    In the arterial phase, the lesion is hardly recognizeble because it is slightly hyperattenuating

     
    Area of Interest: unknown; Imaging Technique: Focal nodular hyperplasia of the liver;

    In the portal venous phase, the lesion is isoattenuating

     
    Area of Interest: unknown; Imaging Technique: Focal nodular hyperplasia of the liver;

    In the delayed phase, the lesion is slightly hypoattenuating

     
    Area of Interest: unknown; Imaging Technique: Focal nodular hyperplasia of the liver;
     
     
  • Figure 2
    Focal nodular hyperplasia of the liver
     

    In the SE T1-weighted image, the lesion is slightly hypointense

     
    Area of Interest: unknown; Imaging Technique: Focal nodular hyperplasia of the liver;

    In the FSE T2-weighted image, the lesion is isointense

     
    Area of Interest: unknown; Imaging Technique: Focal nodular hyperplasia of the liver;

    Dynamic GRE contrast-enhanced MR imaging study:the lesion is isointense throughout the study

     
    Area of Interest: unknown; Imaging Technique: Focal nodular hyperplasia of the liver;

    In the delayed SE T1-weighted image, the lesion is isointense

     
    Area of Interest: unknown; Imaging Technique: Focal nodular hyperplasia of the liver;
     
     
  • Figure 3
    Focal nodular hyperplasia of the liver
     

    No intranodular blood flow signals are detected within the lesion at conventional power Doppler US

     
    Area of Interest: unknown; Imaging Technique: Focal nodular hyperplasia of the liver;

    Intratumoral vessels with a stellate aspect, radiating from the center to the periphery of the lesion, are detected at harmonic power Doppler after intravenous administration of an US contrast agent

     
    Area of Interest: unknown; Imaging Technique: Focal nodular hyperplasia of the liver;

    Intratumoral vessels show pulsatile arterial flow at Doppler spectral analysis

     
    Area of Interest: unknown; Imaging Technique: Focal nodular hyperplasia of the liver;

    Time-intensity wash in-wash out curve:time-intensity analysis of the lesion enhancement curve shows a rapid peak of enhancement in the arterial phase, followed by rapid decrease in the venous phase

     
    Area of Interest: unknown; Imaging Technique: Focal nodular hyperplasia of the liver;
     
     
The lesion is located in the II hepatic segment and is isoattenuating to normal liver parenchyma (ie, not detected) in the unenhanced spiral CT image
 
In the arterial phase, the lesion is hardly recognizeble because it is slightly hyperattenuating
 
In the portal venous phase, the lesion is isoattenuating
 
In the delayed phase, the lesion is slightly hypoattenuating
 
In the SE T1-weighted image, the lesion is slightly hypointense
 
In the FSE T2-weighted image, the lesion is isointense
 
Dynamic GRE contrast-enhanced MR imaging study:the lesion is isointense throughout the study
 
In the delayed SE T1-weighted image, the lesion is isointense
 
No intranodular blood flow signals are detected within the lesion at conventional power Doppler US
 
Intratumoral vessels with a stellate aspect, radiating from the center to the periphery of the lesion, are detected at harmonic power Doppler after intravenous administration of an US contrast agent
 
Intratumoral vessels show pulsatile arterial flow at Doppler spectral analysis
 
Time-intensity wash in-wash out curve:time-intensity analysis of the lesion enhancement curve shows a rapid peak of enhancement in the arterial phase, followed by rapid decrease in the venous phase
 
 
 
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