Presentation
Follow-up incidental liver lesion.
Patient Data
Iso-to-hypoechoic segment 3 lesion measures 4.4 x 3.6 x 4.8 cm has central vascularity. Remainder of the liver is normal.
Arterially hyperenhancing mass with a central non-enhancing scar in liver segment 3. On the non-contrast the mass is isodense to liver parenchyma, and slightly hypodense on portal venous phase.
Free gas from recent laparoscopic appendectomy.
Case Discussion
Typical appearances of focal nodular hyperplasia (FNH), as an arterial enhancing but portal venous phase isodense lesion with a central nonenhancing scar. If further imaging is required for reassurance MRI with hepatocyte-specific contrast would be useful and should show the scar as T2 hyperintense, same arterial and portal phase imaging as on CT, and remaining isointense to liver on the hepatocyte phase.
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