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Radiologic features of focal nodular hyperplasia. Comparison with hepatocellular carcinoma by angiography and CT scan]
Authors:K Ohno  N Moriyama  K Takayasu  Y Muramatsu  K Terui  H Matsue  T Yamada
Affiliation:Department of Diagnostic Radiology.
Abstract:Radiographic features of eight focal nodular hyperplasia (FNH) of livers of 6 patients were described in comparison with those of 72 hepatocellular carcinoma (HCC). In arterial angiograms, 3 of the examined 4 FNH showed a large tumor vessel entering the center of the lesion. However, 1 of the examined HCC (1/39) had such a vessel. Tumor vessels in all of the examined FNH (4/4) were mainly curvilinear, without an encased and obstructive appearance. These angiographic features were not found in the examined HCC (0/39). Spoke-wheel patterns of tumor vessels were observed in 2 FNH (2/4) and in 3 HCC (3/39). In CT scan without contrast imaging, 5 HCC (5/39) and 3 FNH (3/5) were isodense. One of HCC (1/50) and 3 FNH (3/5) were isodense in the late phases of dynamic CT images. 4 HCC (4/50) and 4 FNH (4/5) had an irregular margin in the lesions. 5 HCC (5/50) and 4 FNH (4/5) demonstrated central low density areas in lesions in the early phases of dynamic CT imaging. In the late phases of the image, central high density areas in lesions were found in 2 HCC (2/50) and 3 FNH (3/5). Based on the above radiographic features such as a large tumor vessel having a curvilineal appearance, irregular margin of the lesions in FNH, we conclude that it is possible to make a differential diagnosis between FNH and HCC clinically.
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