Abstract
We report a case of focal nodular hyperplasia in a patient for whom gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and histological analysis results were available. Dynamic contrast-enhanced computed tomography showed a well-defined hypervascular lesion 14 mm in diameter with no visible central scars. Gd-EOB-DTPA-enhanced MRI demonstrated strong peripheral enhancement of the lesion during the hepatobiliary phase, resulting in ring-like enhancement. The pathology examination revealed that the lesion was focal nodular hyperplasia (FNH). Immunohistochemistry showed positive expression of OATP8 in the hepatocytes in the peripheral areas of the lesion, whereas expression of OATP8 was lacking in hepatocytes surrounding the central radiating scar. Ring-like enhancement during the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI may be an important clue for the diagnosis of small FNH.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Mortelé KJ, Praet M, Van Vlierberghe H, Kunnen M, Ros PR. CT and MR imaging findings in focal nodular hyperplasia of the liver: radiologic-pathologic correlation. AJR Am J Roentgenol 2000;175:687–692.
Ba-Ssalamah A, Schima W, Schmook MT, Linnau KF, Schibany N, Helbich T, et al. Atypical focal nodular hyperplasia of the liver: imaging features of nonspecific and liverspecific MR contrast agents. AJR Am J Roentgenol 2002;179: 1447–1456.
Grazioli L, Morana G, Federle MP, Brancatelli G, Testoni M, Kirchin MA, et al. Focal nodular hyperplasia: morphological and functional information from MR imaging with gadobenate dimeglumine. Radiology 2001;221:731–739.
Huppertz A, Haraida S, Kraus A, Zech CJ, Scheidler J, Breuer J, et al. Enhancement of focal liver lesions at gadoxetic acidenhanced MR imaging: correlation with histopathologic findings and spiral CT—initial observations. Radiology 2005;234: 468–478.
Zech CJ, Grazioli L, Breuer J, Reiser MF, Schoenberg SO. Diagnostic performance and description of morphological features of focal nodular hyperplasia in Gd-EOB-DTPAenhanced liver magnetic resonance imaging: results of a multicenter trial. Invest Radiol 2008;43:504–511.
Kacl GM, Hagspiel KD, Marincek B. Focal nodular hyperplasia of the liver: serial MRI with Gd-DOTA, superparamagnetic iron oxide, and Gd-EOB-DTPA. Abdom Imaging 1997; 22:264–267.
Karam AR, Shankar S, Surapaneni P, Kim YH, Hussain S. Focal nodular hyperplasia: central scar enhancement pattern using gadoxetate disodium. J Magn Reson Imaging 2010;32: 341–344.
Kitao A, Zen Y, Matsui O, Gabata T, Kobayashi S, Koda W, et al. Hepatocellular carcinoma: signal intensity at gadoxetic acid-enhanced MR imaging—correlation with molecular transporters and histopathologic features. Radiology 2010;256: 817–826.
Tsuboyama T, Onishi H, Kim T, Akita H, Hori M, Tatsumi M, et al. Hepatocellular carcinoma: hepatocyte-selective enhancement at gadoxetic acid-enhanced MR imaging—correlation with expression of sinusoidal and canalicular transporters and bile accumulation. Radiology 2010;255:824–833.
Vander Borght S, Libbrecht L, Blokzijl H, Faber KN, Moshage H, Aerts R, et al. Diagnostic and pathogenetic implications of the expression of hepatic transporters in focal lesions occurring in normal liver. J Pathol 2005;207:471–482.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Fujiwara, H., Sekine, S., Onaya, H. et al. Ring-like enhancement of focal nodular hyperplasia with hepatobiliary-phase Gd-EOB-DTPA-enhanced magnetic resonance imaging: radiological-pathological correlation. Jpn J Radiol 29, 739–743 (2011). https://doi.org/10.1007/s11604-011-0624-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11604-011-0624-4