title: Hypervascular liver lesions: differentiation of focal nodular hyperplasia from malignant tumors with dynamic gadolinium-enhanced MR imaging.
abstract: The differentiating points between focal nodular hyperplasia (FNH) and malignant hypervascular liver lesions were studied at dynamic gadolinium-enhanced magnetic resonance (MR) imaging. Thirty-six patients with 50 hypervascular lesions (28 FNH, 12 hepatocellular carcinoma, nine metastases, and one cholangiocarcinoma) underwent unenhanced spin-echo (SE) T1- and T2-weighted imaging and T1-weighted gradient-recalled-echo imaging before and repeatedly for 10 minutes after intravenous bolus injection of gadopentetate dimeglumine. On unenhanced SE images, the signal intensity of 25 FNH lesions (89%) and 10 malignant tumors (45%) was homogeneous. A central scar was detected in 12 FNH lesions (43%) and in none of the malignant tumors. On dynamic gadolinium-enhanced images, all lesions had early vigorous enhancement that was homogeneous in 27 FNH lesions (96%) and in seven malignant tumors (32%) (P < .001). After administration of gadopentetate dimeglumine, central scars were seen in 22 FNH lesions (79%) and in one malignant tumor (4%) (P < .001). All FNH lesions (100%) and six malignant tumors (27%) had well-defined enhancement (P < .001). There was overlap in the enhancement pattern between hypervascular malignant lesions and FNH, but by using the combination of unenhanced and enhanced images, they could be distinguished.
authors.affiliation: Department of Radiology, Klinikum Steglitz, Freie Universität Berlin, Germany.
authors.forename: A E
authors.initials: AE
authors.lastname: Mahfouz
authors.forename: B
authors.initials: B
authors.lastname: Hamm
authors.forename: M
authors.initials: M
authors.lastname: Taupitz
authors.forename: K J
authors.initials: KJ
authors.lastname: Wolf
mesh_terms: D000328:Adult; D003287:Contrast Media; D003937:Diagnosis, Differential; D004338:Drug Combinations; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D006965:Hyperplasia; D008099:Liver / Q000098:blood supply / Q000473:pathology*; D008113:Liver Neoplasms / Q000098:blood supply / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid
chemical_list: D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D019786:Gadolinium DTPA