Imaging features of nodular regenerative hyperplasia of the liver mimicking hepatic metastases

Abstract

We described the sonographic, computed tomographic (CT), and magnetic resonance (MR) imaging features of one atypical case of nodular regenerative hyperplasia of the liver. The presence of multiple hepatic nodules suggested the diagnosis of metastatic disease to the liver because of a peripheral rim of enhancement on CT obtained after intravenous administration of contrast material and a halo sign on T2-weighted spin-echo MR imaging. Examination of the pathologic specimen obtained after surgical biopsy showed that the nodules were made of hepatocytes, with a nodular arrangement surrounded by peliosis, without fibrosis or cirrhosis. These findings suggested that peliosis may cause peripheral rim of enhancement on CT and halo sign on MR imaging. In light of this case, nodular regenerative hyperplasia of the liver should be considered in the differential diagnosis of hepatic metastases.

A multicenter assessment of liver toxicity by MRI and biopsy in IBD patients on 6-thioguanine

“…Until now, radiological signs of NRH have only been described in case reports or small series [20][21][22][23][24]. The radiological signs of NRH in these publications are diverse and vary from absence of any changes in the liver parenchyma [24] to focal liver lesions with pseudo-tumoral appearance mimicking malignant lesions [21][22][23].…”

Hyperechoic hepatic nodules: Correlation of findings from sonography, CT, and pathologic analysis

“…On sonograms NRH usually appears as hypoechoic or isoechoic masses with anechoic centers (suggesting hemorrhage); on CT the nodules are hypodense, with minimal or no enhancement. 8,9 However, as shown in Figure 8, NRH nodules may also show moderate to severe fatty metamorphosis and no central hemorrhage, with homogeneous hyperechoic features on sonograms and no enhancement on CT scans.…”

Thioguanin-induced nodular regenerative hyperplasia of the liver-ROC analysis of different MR techniques

“…Therefore, NRH is associated with various diseases which potentially cause impairment of hepatic blood flow, such as vasculitis, collagen diseases or haematological disorders [2][3][4][5][6][7]. The clinical presentation and patient's outcome are mostly related to the degree of co-existing portal hypertension and liver insufficiency [8,9].…”