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European Radiology
Published in: European Radiology 10/2011

01-10-2011 | Hepatobiliary-Pancreas

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

Authors: Daniele Marin, Anna Galluzzo, Aurélie Plessier, Giuseppe Brancatelli, Dominique Valla, Valérie Vilgrain

Published in: European Radiology | Issue 10/2011

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Abstract

Purpose

To retrospectively investigate the prevalence, MR findings, natural history, and association with other hepatic lesions of focal nodular hyperplasia (FNH)-like lesions in a cohort of consecutive patients with cavernous transformation of the portal vein (CTPV).

Materials and methods

This retrospective IRB-approved study comprised 58 patients (32 men, 26 women; average age, 50 years) with CTPV who underwent liver MR imaging between 2000 and 2008. MR images were assessed by two radiologists in consensus for the presence of (a) FNH-like lesions and other liver lesions, and (b) other imaging findings. Patients were assigned to a stable or progressive clinical course based on lesion characteristics at follow-up.

Results

Twelve of 58 patients (21%) had 38 FNH-like lesions (average size, 1.3 cm). Common findings of FNH-like lesions were isointensity on T2-weighted images (82%), intense and homogeneous enhancement during the arterial phase, and lack of washout during the hepatic venous and interstitial phases (100%). FNH-like lesions were found with other benign liver lesions (1 hemangioma, 1 adenoma) in two patients. Three (25%) patients with FNH-like lesions showed a progressive clinical course.

Conclusion

FNH-like lesions are commonly detected in patients with CTPV. Most lesions demonstrate benign imaging findings and stable clinical course.
Literature
1.
Webster GJ, Burroughs AK, Riordan SM (2005) Review article: portal vein thrombosis—new insights into aetiology and management. Aliment Pharmacol Ther 21:1–9PubMedCrossRef
2.
Vilgrain V, Condat B, Bureau C et al (2006) Atrophy-hypertrophy complex in patients with cavernous transformation of the portal vein: CT evaluation. Radiology 241:149–155PubMedCrossRef
3.
Tublin ME, Towbin AJ, Federle MP, Nalesnik MA (2008) Altered liver morphology after portal vein thrombosis: not always cirrhosis. Dig Dis Sci 53:2784–2788PubMedCrossRef
4.
Mathieu D, Vasile N, Dibie C, Grenier P (1985) Portal cavernoma: dynamic CT features and transient differences in hepatic attenuation. Radiology 154:743–748PubMed
5.
Choi SH, Lee JM, Lee KH et al (2004) Relationship between various patterns of transient increased hepatic attenuation on CT and portal vein thrombosis related to acute cholecystitis. AJR 183:437–442PubMed
6.
Condat B, Vilgrain V, Asselah T et al (2003) Portal cavernoma-associated cholangiopathy: a clinical and MR cholangiography coupled with MR portography imaging study. Hepatology 37:1302–1308PubMedCrossRef
7.
Ribera Cano A, Debette-Gratien M, Descottes B, Languepin J (2007) Focal nodular hyperplasia involving portal cavernoma. Arch Pediatr 14:1315–1317PubMedCrossRef
8.
Bureau C, Péron JM, Sirach E, Selves J, Otal P, Vinel JP (2004) Liver nodules resembling focal nodular hyperplasia after portal vein thrombosis. J Hepatol 41:499–500PubMedCrossRef
9.
Tanaka M, Wanless IR (1998) Pathology of the liver in Budd-Chiari syndrome: portal vein thrombosis and the histogenesis of veno-centric cirrhosis, veno-portal cirrhosis, and large regenerative nodules. Hepatology 27:488–496PubMedCrossRef
10.
Kondo F (2001) Benign nodular hepatocellular lesions caused by abnormal hepatic circulation: etiological analysis and introduction of a new concept. J Gastroenterol Hepatol 16:1319–1328PubMedCrossRef
11.
Ames JT, Federle MP, Chopra K (2009) Distinguishing clinical and imaging features of nodular regenerative hyperplasia and large regenerative nodules of the liver. Clin Radiol 64:1190–1195PubMedCrossRef
12.
Brancatelli G, Federle MP, Grazioli L, Golfieri R, Lencioni R (2002) Benign regenerative nodules in Budd-Chiari syndrome and other vascular disorders of the liver: radiologic-pathologic and clinical correlation. Radiographics 22:847–862PubMed
13.
Brancatelli G, Federle MP, Grazioli L, Golfieri R, Lencioni R (2002) Large regenerative nodules in Budd-Chiari syndrome and other vascular disorders of the liver: CT and MR imaging findings with clinicopathologic correlation. AJR 178:877–883PubMed
14.
Vilgrain V, Lewin M, Vons C et al (1999) Hepatic nodules in Budd-Chiari syndrome: imaging features. Radiology 210:443–450PubMed
15.
Soyer P, Lacheheb D, Caudron C, Levesque M (1993) MRI of adenomatous hyperplastic nodules of the liver in Budd-Chiari syndrome. J Comput Assist Tomogr 17:86–89PubMedCrossRef
16.
Rha SE, Lee MG, Lee YS et al (2000) Nodular regenerative hyperplasia of the liver in Budd-Chiari syndrome: CT and MR features. Abdom Imaging 25:255–258PubMedCrossRef
17.
Van Gansbeke D, Avni EF, Delcour C, Engelholm L, Struyven J (1985) Sonographic features of portal vein thrombosis. AJR 144:749–752PubMed
18.
Ros PR, Viamonte M Jr, Soila K, Sheldon JJ, Tobias J, Cohen B (1986) Demonstration of cavernomatous transformation of the portal vein by magnetic resonance imaging. Gastrointest Radiol 11:90–92PubMedCrossRef
19.
Wang L, Li ZS, Lu JP, Wang F, Liu Q, Tian JM (2008) Cavernous transformation of the portal vein: three-dimensional dynamic contrast-enhanced MR angiography. Abdom Imaging 33:463–468PubMedCrossRef
20.
Couinaud C (1957) Le foie: études anatomiques et chirurgicales. Masson, Paris, pp 9–12
21.
22.
Minami M, Ohtomo K, Itai Y (2002) In: Itai Y (ed). Central zoneT and peripheral zone T in the liver: analysis by radiologic imaging. Tokyo, Japan7 Medical Tribune Inc.; pp. 6–14
23.
(1995) Terminology of nodular hepatocellular lesions: international working party. Hepatology 22: 983–993
24.
Vilgrain V, Flejou JF, Arrive L et al (1992) Focal nodular hyperplasia of the liver: MR imaging and pathologic correlation in 37 patients. Radiology 184:699–703PubMed
25.
Kim TK, Choi BI, Han JK, Chung JW, Park JH, Han MC (1998) Nontumorous arterioportal shunt in cirrhotic liver mimicking hypervascular tumor: two-phase spiral CT findings. Radiology 208:597–603PubMed
26.
Semelka RC, Brown ED, Ascher SM et al (1994) Hepatic hemangiomas: a multiinstitutional study of appearance on T2-weighted and serial gadolinium-enhanced gradient-echo MR images. Radiology 192:401–406PubMed
27.
Arrive L, Flejou JF, Vilgrain V et al (1994) Hepatic adenoma: MR findings in 51 pathologically proved lesions. Radiology 193:507–512PubMed
28.
Matsui O, Kadoya M, Kameyama T et al (1991) Benign and malignant nodules in cirrhotic livers: distinction based on blood supply. Radiology 178:493–497PubMed
29.
Choi BI, Takayasu K, Han MC (1993) Small hepatocellular carcinomas and associated nodular lesions of the liver: pathology, pathogenesis and imaging findings. AJR 160:1177–1187PubMed
30.
Ishigami K, Yoshimitsu K, Nishihara Y et al (2009) Hepatocellular carcinoma with a pseudocapsule on gadolinium-enhanced MR images: correlation with histopathologic findings. Radiology 250:435–443PubMedCrossRef
31.
Bioulac-Sage P, Balabaud C, Wanless IR (2001) Diagnosis of focal nodular hyperplasia: not so easy. Am J Surg Pathol 25:1322–1325PubMedCrossRef
32.
Brancatelli G, Federle MP, Grazioli L, Blachar A, Peterson MS, Thaete L (2001) Focal nodular hyperplasia: CT findings with emphasis on multiphasic helical CT in 78 patients. Radiology 219:61–68PubMed
33.
Choi CS, Freeny PC (1998) Triphasic helical CT of hepatic focal nodular hyperplasia: incidence of atypical findings. AJR 170:391–395PubMed
34.
Itai Y, Moss AA, Goldberg HI (1982) Transient hepatic attenuation difference of lobar or segmental distribution detected by dynamic computed tomography. Radiology 144:835–839PubMed
35.
Begg CB, McNeil BJ (1988) Assessment of radiologic tests: control of bias and other design considerations. Radiology 167:565–569PubMed
Metadata
Title
Focal nodular hyperplasia-like lesions in patients with cavernous transformation of the portal vein: prevalence, MR findings and natural history
Authors
Daniele Marin
Anna Galluzzo
Aurélie Plessier
Giuseppe Brancatelli
Dominique Valla
Valérie Vilgrain
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
European Radiology / Issue 10/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2161-z

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