The MRI features are most consistent with focal nodular hyperplasia (FNH).

On imaging the main differential diagnoses include:

• hepatic adenoma
  • ​usually more heterogeneous on the portal and delayed phases
  • no gadoxetate retention on delayed phase MR
  • associated with fat, calcification or hemorrhage
• hypervascular hepatic metastases:
  • usually multiple
  • patient known for primary cancer
• hepatocellular carcinoma (HCC)
  • ​ usually in cirrhosis patient
  • vascular invasion
• fibrolamellar hepatocellular carcinoma 
  • radiating/central scar
  • calcification more common 
  • 70% present with metastases
  • biliary, vascular, and nodal invasion