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Benign versus Malignant Hepatic Nodules: MR Imaging Findings with Pathologic Correlation¹

¹ From the Departments of Radiology (S.M.H., G.P.K.), Pathology (P.E.Z.), Surgery (J.N.M.I.), and Hepatology (S.W.S., R.A.d.M.), Erasmus University Medical Center, Dr Molewaterplein 40, 3015 GD Rotterdam, the Netherlands. Recipient of a Certificate of Merit award for an education exhibit at the 2001 RSNA scientific assembly. Received February 6, 2002; revision requested March 26 and received April 30; accepted May 3. Address correspondence to S.M.H. (e-mail: smhussain62@hotmail.com).

According to the currently used nomenclature, there are only two types of hepatocellular nodular lesions: regenerative lesions and dysplastic or neoplastic lesions. Regenerative nodules include monoacinar regenerative nodules, multiacinar regenerative nodules, cirrhotic nodules, segmental or lobar hyperplasia, and focal nodular hyperplasia. Dysplastic or neoplastic nodules include hepatocellular adenoma, dysplastic foci, dysplastic nodules, and hepatocellular carcinoma (HCC). Many of these types of hepatic nodules play a role in the de novo and stepwise carcinogenesis of HCC, which comprises the following steps: regenerative nodule, low-grade dysplastic nodule, high-grade dysplastic nodule, small HCC, and large HCC. State-of-the-art magnetic resonance (MR) imaging facilitates detection and characterization in most cases of hepatic nodules. State-of-the-art MR imaging includes single-shot fast spin-echo imaging, in-phase and opposed-phase T1-weighted gradient-echo imaging, T2-weighted fast spin-echo imaging with fat saturation, and two-dimensional or three-dimensional dynamic multiphase contrast material–enhanced imaging.

© RSNA, 2002

Index Terms: Liver, focal nodular hyperplasia, 761.3198 • Liver, MR, 761.121411, 761.121412, 761.12143 • Liver, nodules, 761.319, 761.32 • Liver neoplasms, diagnosis, 761.319, 761.32

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