Cirrhotic liver nodules - differential

Last revised by Yahya Baba on 30 Aug 2021

Differential diagnoses of cirrhotic liver nodules include regenerative liver nodules, dysplastic liver nodules, and hepatocellular carcinoma (HCC), all represent a spectrum of diseases ranging from non-neoplastic reparative process (regenerative) to nuclear atypia (dysplastic) to typical neoplasia (HCC). It's not always possible to differentiate the three types of lesion on imaging, however, there are some suggestive features that may favor either one. These features are summarized in this article.

  • numerous (thousands) micro (< 3 mm) nodules, but can be single/few macro (> 3 mm) or giant (> 5 mm) nodules
  • invisible on non-contrast CT, except for siderotic nodules which appear hyperdense
  • siderotic nodules show blooming artifact on T2*
  • do not enhance, or enhances similar to or lower than the liver parenchyma
  • no arterial hyperenhancement
  • single, or few nodules
  • can be hypo-, iso-, or hyperdense on CT
  • early arterial enhancement without washout on later phases
  • iso- to hypointense on T2WI
  • no restricted diffusion
  • often hypodense on CT
  • early arterial enhancement with washout on later phases
  • slightly hyperintense on T2WI
  • may show restricted diffusion

ADVERTISEMENT: Supporters see fewer/no ads

Updating… Please wait.

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

 Thank you for updating your details.