Confident non-invasive diagnosis of pseudolesions of the liver using diffusion-weighted imaging at 3T MRI

Fruehwald-Pallamar, Julia; Bastati-Huber, N.; Fakhrai, Negar; Jantsch, Marion; Puchner, Stefan B.; Herneth, Andreas M.; Ba‐Ssalamah, Ahmed

doi:10.1016/j.ejrad.2011.03.072

Cited by 15 publications

(5 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2,11,17,31 The absence of a correlate of this hypervascular lesion on the DWI is again in favour of MRN and against metastasis. 32,33 As expected, all FNH and MRN nodules in our series showed contrast uptake in the hepatobiliary phase after gadoxetic acid administration similar or higher than the surrounding liver. This reflects their benign hepatocellular origin with preservation of the active membrane transport system via the surface receptors OATPB1/3, a feature that allows prompt discrimination from poorly differentiated HCC and liver metastases.…”

Section: Discussionsupporting

confidence: 82%

Liver Multiacinar Regenerative Nodules: Imaging Findings and Clinical Implications

Donato¹,

Andrade²,

Bastati

et al. 2018

Acta Med Port

Self Cite

View full text Add to dashboard Cite

RESUMOIntrodução: Nódulos regenerativos multiacinares são nódulos hepatocelulares benignos relacionados com alterações vasculares hepáticas. São muito semelhantes à hiperplasia nodular focal mas ocorrem num contexto diferente de doença hepática crónica. O objectivo deste trabalho foi descrever os achados imagiológicos principais destes nódulos e compará-los com um grupo controlo de hiperplasia nodular focal. Material e Métodos: Foi efectuada uma revisão cega de estudos por ressonância magnética de 26 casos de nódulos regenerativos multiacinares e 25 de hiperplasia nodular focal, sendo os dois grupos comparados quanto à dimensão das lesões, morfologia, margens, estrutura, aspecto em T1, T2, difusão e após contraste (incluindo na fase hepatobiliar), presença de cicatriz central e halo hipointenso. Resultados: Foram encontradas diferenças significativas entre nódulos regenerativos multiacinares e hiperplasia nodular focal quanto às dimensões das lesões (mediana 2,35 cm AIQ: 2,13 vs 6,00 cm AIQ: 5,20 respectivamente, p < 0,001), presença de halo hipointenso após contraste (n = 9 vs n = 2, p = 0,038) e de cicatriz central (n = 9 vs n = 20, p = 0,002). Não se observaram outras diferenças significativas. Discussão: Nódulos regenerativos multiacinares e hiperplasia nodular focal são globalmente muito semelhantes mas a ausência de cicatriz central e a presença de halo hipointenso deve sugerir o diagnóstico de nódulos regenerativos multiacinares. Conclusão: O reconhecimento dos achados imagiológicos de nódulos regenerativos multiacinares pode explicar alguns dos casos atípicos de hiperplasia nodular focal e prevenir biopsias desnecessárias. Pode também desencadear uma investigação mais aprofundada de anomalias vasculares hepáticas subjacentes eventualmente desconhecidas.ABSTRACT Introduction: Multiacinar regenerative nodules are benign hepatocellular nodules related to vascular disturbances of the liver. They strongly resemble conventional focal nodular hyperplasia but are connected to different clinical settings, typically chronic liver disease.The purpose of the present study was to describe the key imaging features of these lesions and compare them with a control arm of focal nodular hyperplasia. Material and Methods: A blinded consensus review of liver magnetic resonance consisting of 26 cases of multiacinar regenerative nodules and 25 cases of focal nodular hyperplasia was performed. Lesion size, shape, margins, structure, T1 and T2 signal intensity, diffusion and contrast-enhanced features (including hepatobiliary phase), presence of a central scar and of a peripheral hypointense rim were compared between the two groups. Results: Significant differences between multiacinar regenerative nodules and focal nodular hyperplasia included size (median 2.35 cm, IQR: 2.13, vs 6.00 cm, IQR: 5.20, respectively, p < 0.001), presence of a peripheral hypointense rim after contrast (n = 9 vs n = 2 cases, p = 0.038) and of a central scar (n = 9 vs n = 20, p = 0.002). There were no other significant differences. Discussion: Overall m...

show abstract

Section: Discussionsupporting

confidence: 82%

Liver Multiacinar Regenerative Nodules: Imaging Findings and Clinical Implications

Donato¹,

Andrade²,

Bastati

et al. 2018

Acta Med Port

Self Cite

View full text Add to dashboard Cite

show abstract

“…In conclusion, this case highlights the challenge of differentiating between hepatic pseudolesions caused by inhomogeneous fat distribution and true metastatic lesions. T1w opposed-phase imaging, diffusionweighted imaging and hepatobiliary phase imaging after the administration of hepatocyte-specific contrast agents are crucial in making this distinction (4)(5). The use of CEUS as a follow-up tool further aids in confirming the non-metastatic nature of such findings.…”

Section: Discussionmentioning

confidence: 99%

Inhomogeneous Focal Fat Distribution as Pseudolesions in a Patient with Pancreatic Carcinoma

Weiss,

Maurer

2024

Swiss J Rad Nucl Med

View full text Add to dashboard Cite

This case highlights the challenge of differentiating between hepatic pseudolesions caused by inhomogeneous fat distribution and true metastatic lesions. T1w opposed-phase imaging, diffusion-weighted imaging and hepatobiliary phase imaging after the administration of hepatocyte-specific contrast agents are crucial in making this distinction (4-5). The use of CEUS as a follow-up tool further aids in confirming the non-metastatic nature of such findings.

show abstract

“…MRI can be used to detect a pseudolesion [15], and high-quality 3 T MRI has been reported to be helpful in diagnosing a hypervascularpseudolesion [16]. Out-of-phase T1 weighted MRI images show a loss of signal in the pseudolesion that is related to the presence of microscopic fat [17].…”

Section: Discussionmentioning

confidence: 99%

Treatment of a non-typical hepatic pseudolesion complicated by greatly elevated alpha fetoprotein: case report and literature review

Liu

Zhang

et al. 2013

World J Surg Onc

View full text Add to dashboard Cite

BackgroundHepatic pseudolesions detected by helical computed tomography (CT) are not rare, but it is difficult to make a final diagnosis when the hepatic lesion is complicated by the presence of greatly elevated alpha fetoprotein (AFP). Clinical treatment of non-typical hepatic pseudolesions complicated by greatly elevated AFP should confirm the diagnosis and minimize trauma.Case presentationNon-invasive procedures including ultrasonography, CT, and micro-invasive digital subtraction angiography could not safely differentiate this lesion from a malignant focus when it was complicated by greatly elevated AFP. Laparoscopic hepatectomy was performed, and pathological analysis showed chronic hepatitis, nodular regenerative hyperplasia, focal nodular hyperplasia of the liver, and mild vascular malformation. The tissue was HbsAg(−), HbcAg(−), and AFP(+).ConclusionHeightened awareness of hepatic pseudolesion complicated by primarily elevated AFP will help physicians avoid unnecessary invasive procedures. Hepatic biopsy is inevitable because of greatly elevated AFP. For suspected hepatic pseudolesion with elevated AFP, needle-core biopsy and follow-up surveillance instead of hepatectomy are recommended to find the source of AFP and make a final diagnosis of pseudolesion.

show abstract

Confident non-invasive diagnosis of pseudolesions of the liver using diffusion-weighted imaging at 3T MRI

Cited by 15 publications

References 45 publications

Liver Multiacinar Regenerative Nodules: Imaging Findings and Clinical Implications

Liver Multiacinar Regenerative Nodules: Imaging Findings and Clinical Implications

Inhomogeneous Focal Fat Distribution as Pseudolesions in a Patient with Pancreatic Carcinoma

Treatment of a non-typical hepatic pseudolesion complicated by greatly elevated alpha fetoprotein: case report and literature review

Contact Info

Product

Resources

About