Skip to main content
Top
Published in: Abdominal Radiology 11/2020

01-11-2020 | Magnetic Resonance Imaging | Special Section: Chronic Liver Disease

Hepatic nodules with arterial phase hyperenhancement and washout on enhanced computed tomography/magnetic resonance imaging: how to avoid pitfalls

Authors: Mimi Tang, Yin Li, Zhi Lin, Bingqi Shen, Mengqi Huang, Zi-Ping Li, Xuehua Li, Shi-Ting Feng

Published in: Abdominal Radiology | Issue 11/2020

Login to get access

Abstract

This essay aimed to illustrate the various hepatic nodules that may exhibit arterial phase hyperenhancement and washout on computed tomography/magnetic resonance imaging (CT/MRI). Hepatic nodules with arterial phase hyperenhancement and washout on CT/MRI include hepatocellular carcinoma, focal nodular hyperplasia-like nodules, serum amyloid A-positive hepatocellular neoplasms, intrahepatic cholangiocarcinoma, intrahepatic bile duct adenoma, hepatoblastoma, hepatocellular adenoma, hepatic epithelioid angiomyolipoma, and metastasis including neuroendocrine and gastrointestinal stromal tumors. Understanding the imaging findings is important to ensure correct diagnosis.
Literature
1.
go back to reference Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, Abecassis MM, Roberts LR, Heimbach JK (2018) Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology 68 (2):723-750. https://doi.org/10.1002/hep.29913CrossRefPubMed Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, Abecassis MM, Roberts LR, Heimbach JK (2018) Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology 68 (2):723-750. https://​doi.​org/​10.​1002/​hep.​29913CrossRefPubMed
9.
go back to reference Iannaccone R, Piacentini F, Murakami T, Paradis V, Belghiti J, Hori M, Kim T, Durand F, Wakasa K, Monden M, Nakamura H, Passariello R, Vilgrain V (2007) Hepatocellular carcinoma in patients with nonalcoholic fatty liver disease: helical CT and MR imaging findings with clinical-pathologic comparison. Radiology 243 (2):422-430. https://doi.org/10.1148/radiol.2432051244CrossRefPubMed Iannaccone R, Piacentini F, Murakami T, Paradis V, Belghiti J, Hori M, Kim T, Durand F, Wakasa K, Monden M, Nakamura H, Passariello R, Vilgrain V (2007) Hepatocellular carcinoma in patients with nonalcoholic fatty liver disease: helical CT and MR imaging findings with clinical-pathologic comparison. Radiology 243 (2):422-430. https://​doi.​org/​10.​1148/​radiol.​2432051244CrossRefPubMed
15.
go back to reference Yoneda N, Matsui O, Kitao A, Kozaka K, Kobayashi S, Sasaki M, Yoshida K, Inoue D, Minami T, Gabata T (2016) Benign Hepatocellular Nodules: Hepatobiliary Phase of Gadoxetic Acid-enhanced MR Imaging Based on Molecular Background. Radiographics : a review publication of the Radiological Society of North America, Inc 36 (7):2010–2027. https://doi.org/10.1148/rg.2016160037 Yoneda N, Matsui O, Kitao A, Kozaka K, Kobayashi S, Sasaki M, Yoshida K, Inoue D, Minami T, Gabata T (2016) Benign Hepatocellular Nodules: Hepatobiliary Phase of Gadoxetic Acid-enhanced MR Imaging Based on Molecular Background. Radiographics : a review publication of the Radiological Society of North America, Inc 36 (7):2010–2027. https://​doi.​org/​10.​1148/​rg.​2016160037
16.
go back to reference Kim JW, Lee CH, Kim SB, Park BN, Park YS, Lee J, Park CM (2017) Washout appearance in Gd-EOB-DTPA-enhanced MR imaging: A differentiating feature between hepatocellular carcinoma with paradoxical uptake on the hepatobiliary phase and focal nodular hyperplasia-like nodules. J Magn Reson Imaging 45 (6):1599-1608. https://doi.org/10.1002/jmri.25493CrossRefPubMed Kim JW, Lee CH, Kim SB, Park BN, Park YS, Lee J, Park CM (2017) Washout appearance in Gd-EOB-DTPA-enhanced MR imaging: A differentiating feature between hepatocellular carcinoma with paradoxical uptake on the hepatobiliary phase and focal nodular hyperplasia-like nodules. J Magn Reson Imaging 45 (6):1599-1608. https://​doi.​org/​10.​1002/​jmri.​25493CrossRefPubMed
18.
go back to reference Sasaki M, Yoneda N, Sawai Y, Imai Y, Kondo F, Fukusato T, Yoshikawa S, Kobayashi S, Sato Y, Matsui O, Nakanuma Y (2015) Clinicopathological characteristics of serum amyloid A-positive hepatocellular neoplasms/nodules arising in alcoholic cirrhosis. Histopathology 66 (6):836-845. https://doi.org/10.1111/his.12588CrossRefPubMed Sasaki M, Yoneda N, Sawai Y, Imai Y, Kondo F, Fukusato T, Yoshikawa S, Kobayashi S, Sato Y, Matsui O, Nakanuma Y (2015) Clinicopathological characteristics of serum amyloid A-positive hepatocellular neoplasms/nodules arising in alcoholic cirrhosis. Histopathology 66 (6):836-845. https://​doi.​org/​10.​1111/​his.​12588CrossRefPubMed
25.
go back to reference Fred TB, Fatima C, Ralph HH, Neil DT (2010) WHO classification of tumours of the digestive system. International Agency for Research on Cancer, Lyon Fred TB, Fatima C, Ralph HH, Neil DT (2010) WHO classification of tumours of the digestive system. International Agency for Research on Cancer, Lyon
28.
go back to reference Rodriguez-Galindo C, Krailo M, Frazier L, Chintagumpala M, Amatruda J, Katzenstein H, Malogolowkin M, Spector L, Pashankar F, Meyers R, Tomlinson G, Committee COGRTD (2013) Children's Oncology Group's 2013 blueprint for research: rare tumors. Pediatr Blood Cancer 60 (6):1016-1021. https://doi.org/10.1002/pbc.24428CrossRefPubMed Rodriguez-Galindo C, Krailo M, Frazier L, Chintagumpala M, Amatruda J, Katzenstein H, Malogolowkin M, Spector L, Pashankar F, Meyers R, Tomlinson G, Committee COGRTD (2013) Children's Oncology Group's 2013 blueprint for research: rare tumors. Pediatr Blood Cancer 60 (6):1016-1021. https://​doi.​org/​10.​1002/​pbc.​24428CrossRefPubMed
32.
go back to reference Chung EM, Lattin GE, Jr., Cube R, Lewis RB, Marichal-Hernández C, Shawhan R, Conran RM (2011) From the archives of the AFIP: Pediatric liver masses: radiologic-pathologic correlation. Part 2. Malignant tumors. Radiographics : a review publication of the Radiological Society of North America, Inc 31 (2):483–507. https://doi.org/10.1148/rg.312105201 Chung EM, Lattin GE, Jr., Cube R, Lewis RB, Marichal-Hernández C, Shawhan R, Conran RM (2011) From the archives of the AFIP: Pediatric liver masses: radiologic-pathologic correlation. Part 2. Malignant tumors. Radiographics : a review publication of the Radiological Society of North America, Inc 31 (2):483–507. https://​doi.​org/​10.​1148/​rg.​312105201
Metadata
Title
Hepatic nodules with arterial phase hyperenhancement and washout on enhanced computed tomography/magnetic resonance imaging: how to avoid pitfalls
Authors
Mimi Tang
Yin Li
Zhi Lin
Bingqi Shen
Mengqi Huang
Zi-Ping Li
Xuehua Li
Shi-Ting Feng
Publication date
01-11-2020

Other articles of this Issue 11/2020

Abdominal Radiology 11/2020 Go to the issue

Special Section: chronic liver disease

MR imaging assessment and quantification of liver iron