IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Focal nodular hyperplasia

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Past history celiac disease. Abdominal pain. Incidental finding on hepatic ultrasound. MRI for lesion characterization. Recently started oral contraceptives.

Patient Data

Age: 16 years
Gender: Female

Routine study with use of...

mri

Routine study with use of hepatocyte contast agent Primovist gadoxetic acid

Well-defined nodule in segment 3 with isointense periphery and subtle hyperintense center. Early enhancement of mass, slightly increased over the adjacent liver parenchyma. Delayed (60 mins) scan shows persistent peripheral enhancement of the mass with central stellate "washout". b value = 800 with minimal signal in the mass indicating non-restriction of diffusion.

Case Discussion

Appearances are typical of FNH, i.e. well-defined margins, early peripheral enhancement (> than surrounding liver), persistent peripheral enhancement with Primovist indicating the presence of hepatocytes, non-restriction of diffusion and central stellate scar showing subtle T2 brightening and non-persistent enhancement on delayed scanning.  The early (arterial phase) enhancement is often a little more intense.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

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

 Thank you for updating your details.