Hepatic nodular regenerative lesions in patients with hereditary haemorrhagic telangiectasia: computed tomography and magnetic resonance findings.
OBJECTIVE
This study was done to evaluate the prevalence of regenerative hepatic nodules in patients with hereditary haemorrhagic telangiectasia (HHT).


METHODS
Between February 2001 and December 2010, 171 consecutive HHT patients (95 men and 76 women) were studied with triphasic multidetector computed tomography (MDCT) in 91 cases, magnetic resonance imaging (MRI) in 34 cases and both in the remaining 46 cases. The presence of diffuse vascular abnormalities and focal liver lesions were recorded.


RESULTS
Hepatic arteriovenous malformations (HAVMs) were found in 126/171 (74%) patients. Arteriovenous shunts were found in 24/171 (14%) cases, arterioportal shunts in 52/171 (30%), mixed shunts in 26/171 (15%), telangiectases in 84/171 (49%) and transient hepatic attenuation differences (THADs) in 70/171 (41%). Hepatic nodular lesions were found in 6/171 (3.5%) patients (three men; three women). In 5/6 cases, vascular abnormalities were also evident. Two patients had a single lesion; four had multiple lesions. No lesion showed a central scar.


CONCLUSIONS
Hyperenhancing hepatic regenerative lesions have a high prevalence in HHT patients, representing the response of liver parenchyma to hypoperfusion caused by HAVMs. These lesions are often multiple and may lead to nodular regenerative hyperplasia.
Sezione di Diagnostica per Immagini, Centro Interdipartimentale per lo Studio dell'HHT, Università degli Studi di Bari, Azienda Universitario-Ospedaliera Consorziale Policlinico, Bari, Italy.
A
A
Scardapane
M
M
Ficco
C
C
Sabbà
F
F
Lorusso
M
M
Moschetta
N
N
Maggialetti
P
P
Suppressa
G
G
Angelelli
A A
AA
Stabile Ianora
D000328:Adult; D000792:Angiography / Q000379:methods; D001165:Arteriovenous Malformations / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D003287:Contrast Media; D003911:Dextrans; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008099:Liver / Q000098:blood supply*; D008107:Liver Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D008115:Liver Regeneration; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009942:Organometallic Compounds; D015995:Prevalence; D012189:Retrospective Studies; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; C065507:ferumoxides