Nodular regenerative hyperplasia of the liver in Budd–Chiari syndrome: CT and MR features

Abstract

We report the imaging findings of spiral computed tomography (CT), magnetic resonance (MR) imaging, and MR angiography in a patient with nodular regenerative hyperplasia of the liver associated with Budd-Chiari syndrome. Spiral CT showed multiple enhancing nodules during the hepatic arterial and portal venous phases. MR images showed multiple hyperintense nodules on T1-weighted images and hypointense or isointense nodules on T2-weighted images. MR angiography showed thrombotic occlusion of three hepatic veins, suggesting Budd-Chiari syndrome.

Focal nodular hyperplasia-like lesions in patients with cavernous transformation of the portal vein: prevalence, MR findings and natural history

“…These lesions represent a benign hyperplasia of the hepatic parenchyma in response to increased arterial perfusion in areas with reduced or absent portal blood flow. While accurate diagnosis of these benign lesions is critical to avoid unnecessary intervention, only two isolated case reports, to our knowledge, have described the imaging characteristics of FNH-like lesions in patients with CTPV [15,16].…”

Coexistence of nodular regenerative hyperplasia of the liver and pulmonary arterial hypertension in patients with connective tissue diseases: report of three cases and review of the literature

“…32 When viewed by magnetic resonance imaging, the nodules often have a diffuse high signal intensity on T1-weighted images and isointensity on T2-weighted images, and range from a few millimeters to several centimeters in diameter. 33,34 Since hyperplastic regenerative nodules consist of normal hepatocytes and Kupffer cells that take up contrast agents, they do not show up as defects on superparamagnetic iron oxide-enhanced MRI (SPIO-MRI). 35 These findings are helpful for making a differential diagnosis between NRH and hepatocellular carcinoma.…”

Evaluation of nonmalignant liver masses

“…MRI findings are variable and are not described well in the literature. Nodules may be hyperintense on T1 weighted images and may be variably isointense, slightly hypointense, or hyperintense on T2 weighted images [62].…”

“…Liver cysts are divided into "true" or "false," depending on the presence of an epithelial lining [62]. The following entities are considered true cysts: congenital cysts (simple cysts and polycystic liver disease), parasitic (hydatid) cysts caused by Echinococcus granulosus and multilocularis, neoplastic cysts (cystadenoma, cystadenocarcinoma, cystic sarcoma, squamous cell carcinoma, and metastatic pancreatic, ovarian, colon, renal, and neuroendocrine cancers), and biliary duct-related (Caroli disease, bile duct duplication, and peribiliary cysts) [63].…”