MR imaging of hypervascular lesions in the cirrhotic liver: a diagnostic dilemma

Radiographics : a Review Publication of the Radiological Society of North America, Inc
Daniella B ParenteRosana S Rodrigues

Abstract

Cirrhosis is characterized by a spectrum of hepatocellular nodules that mark the progression from regenerative nodules to low- and high-grade dysplastic nodules, followed by small and large hepatocellular carcinomas (HCCs). Characterization of small nodules on the basis of imaging and histopathologic findings is complicated by an overlap in findings associated with each type of nodule, a reflection of their multistep transitions. Vascularity patterns change gradually as the nodules evolve, with an increasing shift from predominantly venous to predominantly arterial perfusion. Regenerative and low-grade dysplastic nodules demonstrate predominantly portal perfusion and contrast enhancement similar to that of surrounding parenchyma. Differentiation of high-grade dysplastic nodules and well-differentiated HCCs on the basis of dynamic imaging and histologic findings is challenging, with a high rate of false-negative results. Some small nodules that lack hypervascularity may be early HCCs. Progressed small and large HCCs usually present no diagnostic difficulty because of their characteristic findings. Although characterization of hypervascular lesions in the cirrhotic liver is difficult, it is a key step in disease management and is...Continue Reading

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Citations

Mar 11, 2015·Journal of Clinical and Experimental Hepatology·Samir ShahBhawan Paunipagar
Oct 11, 2013·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Sinead H McEvoyDermot E Malone
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Dec 14, 2019·Abdominal Radiology·Christopher KlothStefan Andreas Schmidt
Aug 12, 2015·World Journal of Hepatology·António P MatosRichard C Semelka
Mar 22, 2018·Radiologia brasileira·Daniella Braz ParenteEdson Marchiori
Jul 11, 2021·Magnetic Resonance Imaging Clinics of North America·Silvia D ChangVictoria Chernyak

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