Imaging findings of hepatic focal nodular hyperplasia in men and women: are they really different?

Abstract

Purpose This study was undertaken to compare the imaging findings of focal nodular hyperplasia (FNH) in men and women, as seen on multidetector computed tomography (MDCT), magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS). Materials and methods Two radiologists reviewed 195 imaging studies (17 MDCT, 81 MRI and 97 CEUS examinations) pertaining to 111 FNHs (mean size 3 cm) in 91 patients (mean age 39 years). For each lesion, the readers assessed size, location, echogenicity, attenuation, or signal intensity in comparison with adjacent liver parenchyma on both unenhanced and postcontrast images. Results Eighty-nine FNHs (mean size 3.1 cm) were observed in 73 women (mean age 37.9 years) and 22 FNHs (mean size 2.7 cm) in 18 men (mean age 41.2 years). No statistically significant differences were found between men and women in terms of age, FNH lesions per patient (1.22 and 1.21, respectively), size, baseline and enhancement pattern on MRI, CEUS and MDCT (p \ 0.05). A central scar in FNHs was depicted in 4/18 (22.2 %) men and 16/63 (25.4 %) women on MRI (p \ 0.05), and in 1/2 (50 %) men and 7/15 (46.7 %) women on MDCT (p \ 0.05), whereas a spoke-wheel pattern, central scar, and/or feeding vessel were seen in 5/17 (29.4 %) men and 22/80 (27.5 %) women on CEUS (p \ 0.05).Conclusions Our results did not show any differences in imaging features, age of occurrence and size of FNH between men and women.

Liver Multiacinar Regenerative Nodules: Imaging Findings and Clinical Implications

“…20 Since MRN tended to be significantly smaller than FNH, this could explain the difference in the detection rate of the central scar but it should also be stressed that even larger MRN may not display this imaging feature. 6,9,[22][23][24] The presence of a hypoenhancing rim is an important distinctive finding, present in 35% of MRN against only 8% of FNH. Also coined the halo sign, correlation with the pathological specimen, has showed the presence of peripheral sinusoidal dilatation and vascular congestion in the peri-nodular, atrophic and compressed parenchyma.…”

“…As previously explained the combination of imaging signs, together with the late uptake of hepatocyte-specific contrast agent in the specific clinical context of a non-healthy liver was used as an imperfect standard of reference. 9,23,30 Furthermore, the retrospective nature of the study did not allow verification of the real clinical usefulness concerning different choices for patient management.…”

Split-bolus versus triphasic multidetector-row computed tomography technique in the diagnosis of hepatic focal nodular hyperplasia: a case report

“…Accurate diagnosis is important in FNH as it dictates the course of treatment. In most cases, FNH usually presents with classic CT and MRI features, helping to narrow the differential diagnosis and negating the need for biopsy or further studies [ 9 – 11 ].…”

An elderly man with progressive focal nodular hyperplasia

“…Epidemiologically, FNH occurs more frequently in women of between 20 and 50 years of age; there have been no reports of the progression of FNH in elderly men. The natural course of FNH remains largely unclear as few reports have investigated this issue [7,[9][10][11]. To the best of our knowledge, this is the first reported case in which FNH occurred and the nodules increased in size and number in an elderly man.…”