Urase, A.; Tsurusaki, M.; Kozuki, R.; Kono, A.; Sofue, K.; Ishii, K. Imaging Characteristics of Hypervascular Focal Nodular Hyperplasia-Like Lesions in Patients with Chronic Alcoholic Liver Disease. Preprints2023, 2023121508. https://doi.org/10.20944/preprints202312.1508.v1
APA Style
Urase, A., Tsurusaki, M., Kozuki, R., Kono, A., Sofue, K., & Ishii, K. (2023). Imaging Characteristics of Hypervascular Focal Nodular Hyperplasia-Like Lesions in Patients with Chronic Alcoholic Liver Disease. Preprints. https://doi.org/10.20944/preprints202312.1508.v1
Chicago/Turabian Style
Urase, A., Keitaro Sofue and Kazunari Ishii. 2023 "Imaging Characteristics of Hypervascular Focal Nodular Hyperplasia-Like Lesions in Patients with Chronic Alcoholic Liver Disease" Preprints. https://doi.org/10.20944/preprints202312.1508.v1
Abstract
We evaluated diagnostically differential radiological findings between focal nodular hyperplasia (FNH)-like lesions and hepatocellular carcinoma (HCC). We studied pathologically confirmed FNH-like lesions in 13 alcoholic-cirrhosis patients who were negative for hepatitis-B surface antigen and hepatitis-C virus antibody and underwent dynamic computed tomography (CT) and magnetic resonance imaging (MRI), including superparamagnetic iron oxide (SPIO) and/or gadoxetic acid-enhanced MRI. Seven patients underwent angiography-assisted CT. Evaluated lesion features included arterial enhancement pattern, washout appearance (low density compared to surrounding liver parenchyma), signal intensity on T1-weighted image (T1WI) and T2-weighted image (T2WI), central scar presence, chemical shift on in- and out-of-phase images, and uptake pattern on gadoxetic acid-enhanced MRI hepatobiliary phase and on SPIO-enhanced MRI. Eleven patients had multiple small lesions (<1.5 cm). Radiological features of FNH-like lesions included hypervascularity despite small lesion, lack of “corona-like” enhancement in the late phase on CT during hepatic angiography (CTHA), high-intensity on T1WI, slightly high- or iso-intensity on T2WI, no signal decrease in out-of-phase images, and complete SPIO uptake or incomplete/partial uptake of gadoxetic acid. Pathologically, like HCC, FNH-like lesions showed many unpaired arteries and sinusoidal capillarization. In summary, FNH-like lesions have unique radiological findings useful for differential diagnosis. Specifically, SPIO- and/or gadoxetic acid-enhanced MRI and CTHA features might facilitate differential diagnosis of FNH-like lesions and HCC.
Medicine and Pharmacology, Gastroenterology and Hepatology
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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