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Background
Nodules of various types, including nodular regenerative hyperplasia, focal nodular hyperplasia-like nodules and hepatocellular carcinoma (HCC) have been described on imaging of patients with chronic BCS.
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Imaging findings OR Procedure findings
We reviewed imaging from 26 patients with BCS. 10/26 patients developed new liver nodules on follow-up imaging and 7 of these 10 patients underwent Transjugular Intrahepatic Portosystemic Shunt Procedure (TIPS) prior to development of the nodules. One patient patient developed multofocal HCC and the other 9 are presumed to have benign nodules on the basis of follow-up to date. The 10 patients who developed nodules were imaged with multiphase CT (10 Patients), Gadolinium-enhanced MRI (1...
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Conclusion
Hypervascular nodules are common in patients with BCS. Most are benign, but imaging features can suggest potential HCC. The underlying pathophysiology for the development of these nodules in BCS likely relates to changes in hepatic blood flow.
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Learning objectives
To describe the imaging features, differential diagnosis, pathology and possible aetiology of focal hepatocellular nodules in patients with Budd Chiari Syndrome (BCS).