This site is targeted at medical and radiology professionals, contains user contributed content, and material that may be confusing to a lay audience. Use of this site implies acceptance of our Terms of Use.

Regenerative nodules in liver

Regenerative hepatic nodules (RNs) are a form of non neoplastic nodules that arise in a cirrhotic liver. This may be slightly different from the term nodular regenerative hyperplasia which are  described histopathologically as regenerative nodules with little or no hepatic fibrosis and largely healthy hepatic architecture 1.

They can be of two types:

  • micronodules <3mm
  • macronodules >3mm

There may be accumulation of iron in the nodules when they are termed siderotic nodules.

Radiographic features

CT

Regenerative nodules are rarely visible on non-contrast CT unless they are siderotic. Siderotic regenerative nodules (containing iron) are hyperdense to liver on precontrast imaging and become isodense to liver on post contrast phases. 

They enhance similar to the normal liver parenchyma and thus may not be distinguishable in cirrhotic liver. There is no arterial phase enhancement.

CT arterial portography (CTAP)

RNs are generally visualised as enhancing nodules surrounded by lower attenuation thin septa.

CT hepatic arteriography (CTHA)

RNs are generally visualised as non-enhancing nodules surrounded by enhancing fibrous septa.

CTHA is considered more sensitive than the former in depicting regenerative nodules 4

MRI

Regenerative nodules are common in a cirrhotic liver. About 25% of regenerative liver nodules have increased iron deposition (siderotic nodules) in comparison to normal hepatocytes, which is why they may be hypointense on T2 and T2*.

They usually do not enhance or enhance less than the liver parenchyma.

See also

Article being written please add or edit.

Updating… Please wait.
Loadinganimation

Alert_accept

Error Unable to process the form. Check for errors and try again.

Alert_accept Thank you for updating your details.