Weerakkody Y, Worsley C, Bell D, et al. Dysplastic liver nodules. Reference article, Radiopaedia.org (Accessed on 10 Nov 2024) https://doi.org/10.53347/rID-18138
atypia is insufficient to establish a diagnosis of HCC
may exhibit clone-like features
Radiographic features
Ultrasound
Cirrhotic changes are present but the nodules may not be visualized on ultrasound. A few cases have shown hypo- and hyperechoic nodules and the echogenicity relates to the fat content in the nodule.
CT
Usually hypoattenuating, however, they may be iso- or hyperattenuating to the hepatic parenchyma.
multiphase contrasted images: they may show early arterial uptake but the contrast does not wash out on delayed phase (unlike HCC)
MRI
T1: although the signal intensity may vary broadly, most of them have high T1 signal
IP-OOP: shows fat accumulation characterized by signal drop on the out-of-phase sequence
T2: iso- to hypointense
DWI: no restricted diffusion
T1 C+ (Gd)
high-grade nodules show early contrast enhancement without washout on delayed phase
T2* C+ (SPIO)
low-grade nodules appear hypointense 13
Treatment and prognosis
They are considered premalignant and hence follow-up is necessary. Percutaneous ablation therapy can be considered 9.
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