Presentation
Referred for incidental left hepatic lobe lesion seen on ultrasound.
Patient Data
The MRI study shows a well-defined segment II ( with mild extra hepatic extension) and VII liver lesions which are:
mildly hyperintense on T2
iso/ mildly hypointense on T1
hypervascular on the Gadolinium enhanced arterial phase
slightly hyperintense to the background liver parenchyma on the portovenous phase
homogeneous with the background liver on the late phase
there is a central fibrotic scar which is hypointense on T1, hyperintense on T2 with late contrast enhancement
The ultrasound examination of the left hepatic lesion shows a well-defined isoechoic/ mildly hypoechoic lesion whose color doppler study demonstrates small vessels radiating from the center of the lesion giving the classic "spoke wheel appearance" along with displacement of the peripheral vasculature.
Case Discussion
Imaging findings are consistent with focal nodular hyperplasia.