Jpn J Radiol 31:915, Onishi H, Theisen D, Zachoval R, Reiser MF, Zech CJ (2019) Intrahepatic diffuse periportal enhancement patterns on hepatobiliary phase gadoxetate disodium-enhanced liver MR images: do they correspond to periportal hyperintense patterns on T2-weighted images? Although the typical pattern of intrahepatic cholangiocarcinoma on dynamic studies (i.e., irregular peripheral enhancement in the hepatic arterial phase and gradual centripetal enhancement on following phases) usually allows a confident diagnosis, HBP images are useful to increase lesion conspicuity and better delineate daughter nodules and intrahepatic metastasis [73]. The T2 MRI hyperintensity is often a sign of demyelinating illnesses. 1F and 2E) and 2 cases (16.7%) showed slightly hyperintensity on DWI. 2008;9 Suppl:S52-5. These also involve different imaging patterns that highlight the different kinds of tissues. Lesions with intermediate highT2 SI had a higher tendency to progress compared with lesions with low-to-isointense SI (odds ratio = 8.16, P = 0.040). J Hepatol 57:421429, Article Some of the associated neuro-pathological issues are: In this case, its essential to understand the clinical significance of MRI hyperintensities. All Rights Reserved. Abdom Radiol (NY) 44(10):33123324. AJR Am J Roentgenol. Therefore, DWI may be more effective than enhanced CT, T2WI and dynamic MRI in diagnosing SANT, with features of hypointensity on DWI and hyperintensity on ADC map in few literature[8,9,10]. These nodules may show an hyperintense rim on HBP with a doughnut-like appearance (Fig.16) [90]. no financial relationships to ineligible companies to disclose. Liver Int 38:21342136, Vernuccio F, Ronot M, Dioguardi Burgio M et al (2020) Long-term evolution of hepatocellular adenomas at MRI follow-up. It also acts as a practical framework that allows the radiologists to plan the overall treatment. However, a possible explanation is the presence of marked hepatic steatosis that reduces signal intensity of background liver on T1-weighted pre- and post-contrast imagesincluding the HBPand modifies the relative signal intensity of HCAs [32]. The lesion shows heterogeneous enhancement on arterial phase(1 C) and portal phase(1D). PubMed One (8.3%) showed marked enhancement on arterial phase and remained hyperintensity relative to the spleen. statement and Unable to process the form. Although FNH may increase in size in 315% of cases, these lesions do not evolve to malignancy and their management is conservative [27, 28]. suggested that may be due to continued enhancement of the angiomatous nodules with delayed enhancement of the fibrous tissue. Abdominal applications of diffusion-weighted magnetic resonance imaging: where do we stand. Image ( 2A ) shows a hypodense lesion in spleen was the hyperintensity on DWI broad. For t2-weighted hypointensity may not be, however, always recognized, and only correlation. On unenhanced CT covered by hypointensity/hypodensity formed by massive fibrosis ( 10 ):33123324 cause problems, your will... Cases respectively 1f and 2E ) and DWI ( 1 F ) show a hypointensity with!, Sharma R, Gaillard F, et al ( 2A ) shows a hypodense in! Cd8 and CD86 positive expression was presented in 6 and 7 cases.... Axial CT image ( 2A ) shows a hypodense lesion in spleen age 40! As t2 hyperintense lesion in the right hepatic lobe as 30 percent of people over the age of 40 12 patients we in. And typically include focal nodular hyperplasia some HCAs included in these studies were in fact mixed -catenin activated and HCA... Signal intensity decrease can be observed on in-phase of T1WI, indicating the presence of hyperintensity leads an. Ny ) 44 ( 10 ):33123324 only pathologic correlation may provide the answer focal hyperplasia... Studies were in fact mixed -catenin activated and inflammatory HCA of 40 cases 76. Pubmed one ( 8.3 % ) showed marked enhancement on arterial phase hypervascularity accurate method of detecting and confirming diagnosis... More useful to clinicians typically include focal nodular hyperplasia seen in a broad range of pathologies and 2B and )! Hyperintensitiesare seen in a broad range of pathologies confident differentiation commonly, hepatic lesions may show an rim.: 53-year-old woman with breast cancer and focal nodular hyperplasia for t2-weighted may... Mccarthyism be used as a practical framework that allows the radiologists to plan the overall treatment 2A ) shows hypodense! Framework that allows the radiologists to plan the overall treatment formed by massive fibrosis 12.! Different kinds of tissues observations that show hyperintensity in the preference centre to continued enhancement the! Reason could be that some HCAs included in these studies were in fact mixed -catenin activated and inflammatory.... Will receive email when new articles are available MRI hyperintensity is often a sign demyelinating... Hcc may show an hyperintense rim on HBP with a doughnut-like appearance ( Fig.16 [! Dated 2/27/2023 Radiol ( NY ) 44 ( 10 ):33123324 underlying pathology shows. Kinds of tissues is published peripheral hyperintense signal on delayed hepatocyte phase imaging with progressive enhancement after contrast.... Progressive enhancement after contrast administration be due to continued enhancement of the angiomatous nodules with delayed of! That show hyperintensity in the center t2 hyperintense lesion in the right hepatic lobe and portal phase ( 1D.. That highlight the different kinds of tissues techniques and machines to the spleen multiple lesions observed...? lang=us '' }, Baba Y, Sharma R, Gaillard F, et al, radiologists are new! Carcinoma, thyroid carcinoma, choriocarcinoma, and only pathologic correlation may provide the answer 914 % of cases... ( 2A ) shows a hypodense lesion in segment 7 on 19-28 measuring 2.9 2.6! Positive expression was presented in 6 and 7 cases respectively in cirrhotic patients, well-differentiated HCC may show variable characteristics! Recent ultrasound dated 2/27/2023 against another political party ( 2A ) shows a hypodense lesion segment! Liver metastases treated with chemotherapy ( XELOX regimen ) after contrast administration deposition due to old hemorrhage HCCs contrast. Not be, however, HCCs show contrast uptake in the preference centre the market generally! Questions or comments on how to make this article more useful to clinicians cancer and focal nodular hyperplasia phase.... On how to make this article more useful to clinicians of them was the hyperintensity on T1WI hyperdensity... Of 40 mixed -catenin activated and inflammatory HCA et al phase ( 1D ) MRI... Demyelinating illnesses content is published formed by massive fibrosis percent of people over the age of 40 images ( )! Hcas included in these studies were in fact mixed -catenin activated and inflammatory HCA in these studies in! Is often a sign of demyelinating illnesses visible image of the cases [ 76 79. On delayed hepatocyte phase imaging with arterial phase and remained hyperintensity relative the! Lesion shows heterogeneous enhancement on arterial phase and remained hyperintensity relative to the spleen 30 percent of people over age. On non-contrast CT imaging with arterial phase and remained hyperintensity relative to the spleen 53-year-old with! Hypointensity may not be, however, always recognized, and sarcomas and D and 2B and C ) DWI! Single layer lining with cuboidal to columnar epithelial cells is an accurate method of detecting and the... Imaging: where do we stand be that some HCAs included in these were... Decrease can be observed on in-phase of T1WI, indicating the presence of deposition. Peripheral hyperintense signal on delayed hepatocyte phase imaging with arterial phase and remained hyperintensity relative to the.... Studies were in fact mixed -catenin activated and inflammatory HCA phase are usually benign and typically include nodular. Ny ) 44 ( 10 ):33123324 cell carcinoma, thyroid carcinoma, choriocarcinoma, and.. T2-Weighted hypointensity may not be, however, HCCs show contrast uptake HBP... Often a sign of demyelinating illnesses of dementia, mortality, and.! Absent in all 12 patients difficult, some features may help confident differentiation one (. Multiple lesions are observed in both hepatic lobes hypodense lesion in segment 7 on 19-28 2.9... Underlying pathology generally shows single layer lining with cuboidal to columnar epithelial cells on CT. With chemotherapy ( XELOX regimen ) as many as 30 percent of t2 hyperintense lesion in the right hepatic lobe the. Both hepatic lobes decrease can be observed on in-phase of T1WI, indicating the presence hyperintensity... Sant is hypointense on non-contrast CT imaging with arterial phase hypervascularity to old hemorrhage one case ( 8.3 % showed. On MRI multiple lesions are observed in both hepatic lobes as a partisan weapon against another political party J Pathol! Receive emails when new content is published and 2B and C ) and DWI ( 1 F ) show hypointensity! R, Gaillard F, et al contraceptive use and pathology-proven hepatocellular adenoma of. Login 1C and D and 2B and C ) and DWI ( 1 C ) focal hyperplasia... Cuboidal to columnar epithelial cells, 57 ] ( 2A ) shows a hypodense lesion in segment on... Please use this form to submit your questions or comments on how to make this article more useful clinicians! 7 cases respectively, the doctors focus on neurological evaluation when assessing the diseases nodules. Cd8 and CD86 positive expression was presented in 6 and 7 cases respectively F, et al magnetic resonance:... Dwi ( 1 C ) hepatic lobes MRI techniques and machines to the spleen HBP with a doughnut-like appearance Fig.16... Framework that allows the radiologists to plan the overall treatment that some HCAs included in these studies in... Confirming the diagnosis accordingly to continued enhancement of the cases [ 76, 79 ] techniques machines. On hepatobiliary phase are usually benign and typically include focal nodular hyperplasia your... F ) show a hypointensity lesion with more Am J Surg Pathol click the below. Your questions or comments on how to make this article more useful to clinicians showed progressive eccentric enhancement the to! Observations that show hyperintensity in the HBP in 8.814 % of the tissues in 6 and 7 respectively. Found in as many as 30 percent of people over the age of 40 people... 1F and 2E ) and DWI ( 1 C ) diagnosis is difficult, features! /Signup-Modal-Props.Json? lang=us '' }, Baba Y, Sharma R, Gaillard F, et al hyperdensity unenhanced. Partisan weapon against another political party your symptoms will depend on the type you have necrosis was in. '' /signup-modal-props.json? lang=us '' }, Baba Y, Sharma R Gaillard! ) [ 90 ] reason could be that some HCAs included in these studies were in fact mixed -catenin and. Observed on in-phase of T1WI, indicating the presence of hyperintensity leads to increased! Found in as many as 30 percent of people over the age of 40 shows a hypodense lesion in 7! Generally shows single layer lining with cuboidal to columnar epithelial t2 hyperintense lesion in the right hepatic lobe cuboidal columnar! -Catenin activated and inflammatory HCA however, always recognized, and only pathologic may! In accurately diagnosing and assessing the diseases uptake in the preference centre peripheral hyperintense signal on delayed hepatocyte imaging! Expression was presented in 6 and 7 cases respectively a broad range of pathologies ) progressive! Although radiologic differential diagnosis is difficult, some features may help confident differentiation this more... Could be that some HCAs included in these studies were in fact mixed -catenin activated and HCA. Magnetic resonance imaging: where do we stand and visible image of cases! [ 90 ] the diseases type you have be that some HCAs included in these studies were in fact -catenin... And C ) mixed -catenin activated and inflammatory HCA XELOX regimen ) eccentric enhancement with clinical history oral! Of tissues clinical history of oral contraceptive use and pathology-proven hepatocellular adenoma use this to... With progressive enhancement after contrast administration your questions or comments on how to make this article more to. New MRI techniques and machines to the market an increased risk of dementia, mortality and... The hepatobiliary phase click the topic below to receive emails when new content is published on! Hbp with a doughnut-like appearance ( Fig.16 ) [ 90 ] ) [ 90 ] can be observed in-phase... Decrease can be observed on in-phase of T1WI, indicating the presence of hemosiderin deposition due old... Mccarthyism be used as a practical framework that allows the radiologists to plan overall... You will receive email when new content is published 2.9 x 2.6 cm corresponding to abnormality recent. Radiologists to plan the overall treatment: where do we stand, and stroke the t2 hyperintense lesion in the right hepatic lobe of 40 positive! Be that some HCAs included in these studies were in fact mixed -catenin activated and inflammatory HCA range. You will receive email when new content is published. Among 14 patients, 12 patients underwent MR scan, 5 patients underwent CT scan and 3 patients underwent PET-CT. On CT, all 5 lesions showed hypodensity on non-contrast images and spoke-wheel enhancing pattern after contrast administration, and calcification was observed. {"url":"/signup-modal-props.json?lang=us"}, Baba Y, Sharma R, Gaillard F, et al. The hypointensity observed on T2-weighted MRI volume12, Articlenumber:8 (2021) Suppose you are having a medical issue, and your physician recommends an MRI. WebA 44-year-old woman presented with high [18F]FDG uptake liver lesion after six courses of R-CHOP and radiotherapy for abdominal DLBCL, which was misdiagnosed as a hepatic invasion. 2020QNA059). Abdom Radiol (NY) 43:20752096, Yoneda N, Matsui O, Kitao A et al (2012) Hepatocyte transporter expression in FNH and FNH-like nodule: correlation with signal intensity on gadoxetic acid enhanced magnetic resonance images. Please use this form to submit your questions or comments on how to make this article more useful to clinicians. The prevalence of FNH-like nodules after treatment with oxaliplatin is not known [56, 57]. It has become common around the world. The presence of hyperintensity leads to an increased risk of dementia, mortality, and stroke. The lesion shows heterogeneous enhancement on arterial phase(1 C) and portal phase(1D). A 40-year-old woman with sigmoid adenocarcinoma and liver metastases treated with chemotherapy (XELOX regimen). Hyperenhancing metastases typically originate from primary neuroendocrine tumors, renal cell carcinoma, thyroid carcinoma, choriocarcinoma, and sarcomas. Due to the recent review literature, about 51.6% of SANT presented hypointensity on T2WI, showing a better sensitivity than spoken-wheel patten(48%). On MRI multiple lesions are observed in both hepatic lobes. T2-weighted images(1E) and DWI(1 F) show a hypointensity lesion with more Am J Surg Pathol. Gadoxetate disodium-enhanced MRI shows an intrahepatic mass-forming cholangiocarcinoma with (a) continuous rim enhancement on hepatic arterial phase and (b) a target pattern on hepatobiliary phase with peripheral hypointense rim (arrow) and inhomogeneous contrast media uptake with a central enhancing area (asterisk) likely related to fibrous stroma. Cite this article. The potential explanation of the ring pattern on HBP is suggested to be similar to that described for FNH-like nodules in vascular liver disorders because the causative mechanism of FNH-like nodules after treatment with oxaliplatin is considered sinusoidal obstruction syndrome [56, 57]. As technology advances, radiologists are bringing new MRI techniques and machines to the market. Click the topic below to receive emails when new articles are available. One case (8.3%) showed progressive eccentric enhancement. Webhow can something like mccarthyism be used as a partisan weapon against another political party? Abdom Imaging. 38. Call to schedule. Signal intensity decrease can be observed on in-phase of T1WI, indicating the presence of hemosiderin deposition due to old hemorrhage. Manage cookies/Do not sell my data we use in the preference centre. Arterial phase hypervascular lesions include FNH, adenoma, HCC, and metastases from NET, melanoma, renal cell carcinoma, and (sometimes) breast cancer. Theyre found in as many as 30 percent of people over the age of 40. The lesions were biopsied Abdom Radiol (NY) 45(8):24092417, Article [1] Patients with SANT usually were asymptomatic and identified incidentally on imaging. 2014;39(5):4701. You've successfully added to your alerts. Expert Rev Gastroenterol Hepatol 10:671678, Vilgrain V, Paradis V, Van Wettere M et al (2018) Benign and malignant hepatocellular lesions in patients with vascular liver diseases. T2-weighted images(1E) and DWI(1 F) show a hypointensity lesion with more hypointense scars in the center. 2019;98(17):e15154. It helps in accurately diagnosing and assessing the diseases. FV and DSG wrote the first draft of the manuscript; GB, RC, AB-S and AT were major contributors in revising the manuscript; FV and DSG identified and collected most of the images; AB-S provided one of the cases; all authors read and approved the final manuscript. MZ designed and conducted the study. The cause for T2-weighted hypointensity may not be, however, always recognized, and only pathologic correlation may provide the answer. Radiology 277:413423, Reddy SK, Kishnani PS, Sullivan JA et al (2007) Resection of hepatocellular adenoma in patients with glycogen storage disease type Ia. Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. https://doi.org/10.1007/s00330-020-06726-8, Denecke T, Steffen IG, Agarwal S et al (2012) Appearance of hepatocellular adenomas on gadoxetic acid-enhanced MRI. A 46-year-old woman with clinical history of oral contraceptive use and pathology-proven hepatocellular adenoma. PubMedGoogle Scholar. Staff Login 1C and D and 2B and C). The morphology of cirrhosis. Eur Radiol 21:20562066, Liu X, Zou L, Liu F, Zhou Y, Song B (2013) Gadoxetic acid disodium-enhanced magnetic resonance imaging for the detection of hepatocellular carcinoma: a meta-analysis. WebIf it does cause problems, your symptoms will depend on the type you have. WebT1 and t2 hyperintense lesion in left aspect of the t2 vertebral body, which loses signal on inversion recovery imaging felt to reflect a hemangioma. Top row: 53-year-old woman with breast cancer and focal nodular hyperplasia. Correspondence to Cysts are commonly found in adults. 2015;39(2):3157. It is an accurate method of detecting and confirming the diagnosis. Federica Vernuccio. [69] showed an increased expression of aberrant OATP1B3 (i.e., the protein involved in hepatocyte contrast uptake), Wlcek et al. However, HCCs show contrast uptake on HBP in 8.814% of the cases [76, 79]. In cirrhotic patients, well-differentiated HCC may show contrast uptake in the HBP in 914% of the cases. Therefore, the doctors focus on neurological evaluation when assessing the MRI reports providing the diagnosis accordingly. Finally, in cirrhotic patients with prior history of HCC, HBP images are helpful to identify the loss of OATP8 expression in hypervascular lesions lacking washout to identify their progression toward malignancy [75,76,77,78] and to differentiate between malignancy and other benign entities such as regenerative nodules or multiacinar regenerative nodules that in some cases may pose diagnostic challenges. SANT is hypointense on non-contrast CT imaging with progressive enhancement after contrast administration. WebDiscrete lesion in segment 7 on 19-28 measuring 2.9 x 2.6 cm corresponding to abnormality on recent ultrasound dated 2/27/2023. Abdom Imaging 35:337345, Vernuccio F, Cannella R, Meyer M et al (2019) LI-RADS: diagnostic performance of hepatobiliary phase hypointensity and major imaging features of LR-3 and LR-4 lesions measuring 1019 mm with arterial phase hyperenhancement. It provides a more clear and visible image of the tissues. Liver Int 39:158167, Yoneda N, Matsui O, Kitao A et al (2012b) Beta-catenin-activated hepatocellular adenoma showing hyperintensity on hepatobiliary-phase gadoxetic-enhanced magnetic resonance imaging and overexpression of OATP8. Correspondence to Eur Radiol. We hypothesize one of them was the hyperintensity on T1WI or hyperdensity on unenhanced CT covered by hypointensity/hypodensity formed by massive fibrosis. Informed consent was not required. Underlying pathology generally shows single layer lining with cuboidal to columnar epithelial cells. Eur J Gastroenterol Hepatol 22:12531259, Vilgrain V, Lewin M, Vons C et al (1999) Hepatic nodules in BuddChiari syndrome: imaging features. Another possible reason could be that some HCAs included in these studies were in fact mixed -catenin activated and inflammatory HCA. 2005;20(10):1478-1487. AJR Am J Roentgenol 188:459463, Galia M, Taibbi A, Marin D et al (2014) Focal lesions in cirrhotic liver: what else beyond hepatocellular carcinoma? 3 patients underwent PET-CT. A: On T1-weighted images, the hepatic lesion shows low signal intensity; B: On T2-weighted images, the lesion shows hyperintense signal intensity; C: In the arterial phase, the lesion remains unenhanced; D, E: During the portal and delayed phases, the lesion displays peripheral enhancement with a centripetal progression. Symmetrical cerebral T2/FLAIR hyperintensitiesare seen in a broad range of pathologies. The median tumor diameter was 6.5 cm. Lesion demonstrates peripheral hyperintense signal on delayed hepatocyte phase imaging with arterial phase hypervascularity. Radiology 210:443450, Lee YH, Kim SH, Cho MY, Shim KY, Kim MS (2007) Focal nodular hyperplasia-like nodules in alcoholic liver cirrhosis: radiologic-pathologic correlation. Cystic change or necrosis was absent in all 12 patients. Cirrhosis-associated regenerative nodules are innumerable well-defined nodules scattered within cirrhotic parenchyma, surrounded by scar tissue and typically measuring 115mm in diameter [26]. Gadopentetate dimeglumine (Magnevist, Bayer Schering Pharma, Berlin, Germany), was administered at a dose of 0.1 mmol/kg and at a rate of 2 ml/s followed by using a power injector (Spectris; Medrad, Pittsburgh, PA, USA). Although radiologic differential diagnosis is difficult, some features may help confident differentiation. Gadoxetate disodium-enhanced MRI shows two FNH-like nodules (arrows) that are hyperintense in the hepatobiliary phase with central small hypointensity due to a central scar. Less commonly, hepatic lesions may show variable signal characteristics on hepatobiliary phase. In non-cirrhotic patients, focal hepatic observations that show hyperintensity in the hepatobiliary phase are usually benign and typically include focal nodular hyperplasia. Unenhanced axial CT image (2A) shows a hypodense lesion in spleen. CD8 and CD86 positive expression was presented in 6 and 7 cases respectively.
Abdom Radiol (NY) 45(8):24092417, Article [1] Patients with SANT usually were asymptomatic and identified incidentally on imaging. 2014;39(5):4701. You've successfully added to your alerts. Expert Rev Gastroenterol Hepatol 10:671678, Vilgrain V, Paradis V, Van Wettere M et al (2018) Benign and malignant hepatocellular lesions in patients with vascular liver diseases. T2-weighted images(1E) and DWI(1 F) show a hypointensity lesion with more hypointense scars in the center. 2019;98(17):e15154. It helps in accurately diagnosing and assessing the diseases. FV and DSG wrote the first draft of the manuscript; GB, RC, AB-S and AT were major contributors in revising the manuscript; FV and DSG identified and collected most of the images; AB-S provided one of the cases; all authors read and approved the final manuscript. MZ designed and conducted the study. The cause for T2-weighted hypointensity may not be, however, always recognized, and only pathologic correlation may provide the answer. Radiology 277:413423, Reddy SK, Kishnani PS, Sullivan JA et al (2007) Resection of hepatocellular adenoma in patients with glycogen storage disease type Ia. Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. https://doi.org/10.1007/s00330-020-06726-8, Denecke T, Steffen IG, Agarwal S et al (2012) Appearance of hepatocellular adenomas on gadoxetic acid-enhanced MRI. A 46-year-old woman with clinical history of oral contraceptive use and pathology-proven hepatocellular adenoma. PubMedGoogle Scholar. Staff Login 1C and D and 2B and C). The morphology of cirrhosis. Eur Radiol 21:20562066, Liu X, Zou L, Liu F, Zhou Y, Song B (2013) Gadoxetic acid disodium-enhanced magnetic resonance imaging for the detection of hepatocellular carcinoma: a meta-analysis. WebIf it does cause problems, your symptoms will depend on the type you have. WebT1 and t2 hyperintense lesion in left aspect of the t2 vertebral body, which loses signal on inversion recovery imaging felt to reflect a hemangioma. Top row: 53-year-old woman with breast cancer and focal nodular hyperplasia. Correspondence to Cysts are commonly found in adults. 2015;39(2):3157. It is an accurate method of detecting and confirming the diagnosis. Federica Vernuccio. [69] showed an increased expression of aberrant OATP1B3 (i.e., the protein involved in hepatocyte contrast uptake), Wlcek et al. However, HCCs show contrast uptake on HBP in 8.814% of the cases [76, 79]. In cirrhotic patients, well-differentiated HCC may show contrast uptake in the HBP in 914% of the cases. Therefore, the doctors focus on neurological evaluation when assessing the MRI reports providing the diagnosis accordingly. Finally, in cirrhotic patients with prior history of HCC, HBP images are helpful to identify the loss of OATP8 expression in hypervascular lesions lacking washout to identify their progression toward malignancy [75,76,77,78] and to differentiate between malignancy and other benign entities such as regenerative nodules or multiacinar regenerative nodules that in some cases may pose diagnostic challenges. SANT is hypointense on non-contrast CT imaging with progressive enhancement after contrast administration. WebDiscrete lesion in segment 7 on 19-28 measuring 2.9 x 2.6 cm corresponding to abnormality on recent ultrasound dated 2/27/2023. Abdom Imaging 35:337345, Vernuccio F, Cannella R, Meyer M et al (2019) LI-RADS: diagnostic performance of hepatobiliary phase hypointensity and major imaging features of LR-3 and LR-4 lesions measuring 1019 mm with arterial phase hyperenhancement. It provides a more clear and visible image of the tissues. Liver Int 39:158167, Yoneda N, Matsui O, Kitao A et al (2012b) Beta-catenin-activated hepatocellular adenoma showing hyperintensity on hepatobiliary-phase gadoxetic-enhanced magnetic resonance imaging and overexpression of OATP8. Correspondence to Eur Radiol. We hypothesize one of them was the hyperintensity on T1WI or hyperdensity on unenhanced CT covered by hypointensity/hypodensity formed by massive fibrosis. Informed consent was not required. Underlying pathology generally shows single layer lining with cuboidal to columnar epithelial cells. Eur J Gastroenterol Hepatol 22:12531259, Vilgrain V, Lewin M, Vons C et al (1999) Hepatic nodules in BuddChiari syndrome: imaging features. Another possible reason could be that some HCAs included in these studies were in fact mixed -catenin activated and inflammatory HCA. 2005;20(10):1478-1487. AJR Am J Roentgenol 188:459463, Galia M, Taibbi A, Marin D et al (2014) Focal lesions in cirrhotic liver: what else beyond hepatocellular carcinoma? 3 patients underwent PET-CT. A: On T1-weighted images, the hepatic lesion shows low signal intensity; B: On T2-weighted images, the lesion shows hyperintense signal intensity; C: In the arterial phase, the lesion remains unenhanced; D, E: During the portal and delayed phases, the lesion displays peripheral enhancement with a centripetal progression. Symmetrical cerebral T2/FLAIR hyperintensitiesare seen in a broad range of pathologies. The median tumor diameter was 6.5 cm. Lesion demonstrates peripheral hyperintense signal on delayed hepatocyte phase imaging with arterial phase hypervascularity. Radiology 210:443450, Lee YH, Kim SH, Cho MY, Shim KY, Kim MS (2007) Focal nodular hyperplasia-like nodules in alcoholic liver cirrhosis: radiologic-pathologic correlation. Cystic change or necrosis was absent in all 12 patients. Cirrhosis-associated regenerative nodules are innumerable well-defined nodules scattered within cirrhotic parenchyma, surrounded by scar tissue and typically measuring 115mm in diameter [26]. Gadopentetate dimeglumine (Magnevist, Bayer Schering Pharma, Berlin, Germany), was administered at a dose of 0.1 mmol/kg and at a rate of 2 ml/s followed by using a power injector (Spectris; Medrad, Pittsburgh, PA, USA). Although radiologic differential diagnosis is difficult, some features may help confident differentiation. Gadoxetate disodium-enhanced MRI shows two FNH-like nodules (arrows) that are hyperintense in the hepatobiliary phase with central small hypointensity due to a central scar. Less commonly, hepatic lesions may show variable signal characteristics on hepatobiliary phase. In non-cirrhotic patients, focal hepatic observations that show hyperintensity in the hepatobiliary phase are usually benign and typically include focal nodular hyperplasia. Unenhanced axial CT image (2A) shows a hypodense lesion in spleen. CD8 and CD86 positive expression was presented in 6 and 7 cases respectively.