BMC Medical Imaging Due to the recent review literature, about 51.6% of SANT presented hypointensity on T2WI, showing a better sensitivity than spoken-wheel patten(48%). In patients with primary or secondary vascular disorders, focal nodular hyperplasia-like lesions arise as a local hyperplastic response to vascular alterations and tend to be iso- or hyperintense inthe hepatobiliary phase. Gadoxetic acid, a hepatobiliary-specific contrast medium used for MRI, is becoming increasingly important in the detection and characterization of hepatic mass lesions. 2016;89(1063):20160054. Three types of blood vessels are observed including cord capillaries, splenic sinusoids, and small veins. Radiology 264(3):751760. Iso- or hyperintensity of HCAs on HBP has been reported in a variable percentage, ranging from 0 to 70% [6], and this variability is primarily related to the fact that HCAs include eight different subtypes showing different molecular/genetic background [43]. LBSL. Sclerosing angiomatoid nodular transformation of the spleen mimicking metastasis of melanoma: a case report and review of the literature. Recently, Yoneda et al. Insights Imaging 3(5):451474. FNHs show iso- or hyperintensity in the HBP relatively to liver parenchyma in the vast majority (97%) of cases [10] (Fig.2), and this is attributed to OATP1B3 expression equal or higher than that of the background liver or to an increase in well-differentiated bile ducts in these lesions compared to the surrounding parenchyma [29,30,31,32,33]. Cite this article. 
WebAlthough most lesions, including lipomas, fibromas, and epidermal and ganglion cysts, are benign, rare lesions such as soft tissue sarcomas may have serious consequences. The etiology is unclear, but may result from different mechanisms, including developmental and acquired causes. 3. Hemangioma in the posterior segment of the right liver lobe. [9] This feature was observed in one patient in our study. Middle column: c increased uptake due to overexpression of OATP1B3 and (d) corresponding iso- or hyperintense signal characteristics of focal observations (from left to right: FNH, nodule with hyperintense rim, hyperintense HCC, HCC with nodule-in-nodule architecture and HCC with peritumoral hyperintensity). On T1 weighted imaging, 10 cases (83.3%) were isointense and 2 cases (16.7%) were slightly hypointense. 1B and 2A) and progressive radial heterogeneous enhancement after contrast administration (Figs. In addition to the typical spoke-wheel performance on enhanced images, our study demonstrated that DWI and ADC findings could raise the diagnostic performance for the diagnosis of SANT. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Jpn J Radiol 30:499508, Fujiwara H, Sekine S, Onaya H et al (2011) Ring-like enhancement of focal nodular hyperplasia with hepatobiliary-phase Gd-EOB-DTPA-enhanced magnetic resonance imaging: radiological-pathological correlation. In oncologic patients, hepatobiliary MRI contrast agents increase sensitivity for the detection of metastases as compared to extracellular agents [67, 68], and this is particularly relevant in patients with hepatic steatosis following chemotherapy [93] or for a complete staging in patients with colon cancer that are indicated surgery to uncover small liver metastases prior to surgery. This pictorial essay reviews a broad spectrum of benign and malignant focal hepatic observations that may show hyperintense signal intensity on HBP on MRI in non-cirrhotic patients, in patients with vascular disorders, in oncologic and cirrhotic patients. The lesion shows heterogeneous enhancement on arterial phase(1C) and portal phase(1D). 
Activation of -catenin protein causes uncontrolled hepatocyte proliferation and overexpression of OATP1B3 responsible for iso- or hyperintensity on HBP [32, 45, 46]. Case Discussion On MRI multiple lesions are observed in both hepatic lobes. The T2 MRI hyperintensity is often a sign of demyelinating illnesses. Springer Nature. In 4257% of these tumors, a target sign is demonstrated as a peripheral hypointense rim and a diffuse, mainly central and inhomogeneous EOB-cloud enhancement (Fig.11) [18,19,20]. However, it also exists in young and middle-aged people who have a history of other medical issues. Post-chemotherapy focal nodular hyperplasia-like lesions may be tricky, and their typical hyperintense rim in the hepatobiliary phase is very helpful for the differential diagnosis with metastases. Google Scholar, Mohajer K, Frydrychowicz A, Robbins JB, Loeffler AG, Reed TD, Reeder SB (2012) Characterization of hepatic adenoma and focal nodular hyperplasia with gadoxetic acid. poliomyelitis-like syndrome. The morphology of cirrhosis. You've successfully added to your alerts. Article On CT, all 5 lesions showed hypodensity on non-contrast images (Figs. In addition, practitioners associate it with cerebrovascular disorders and other similar risks. Eur J Radiol 80:e243-1248, Cannella R, Calandra A, Cabibbo G et al (2019) Hyperintense nodule-in-nodule on hepatobiliary phase arising within hypovascular hypointense nodule: outcome and rate of hypervascular transformation. Webhow can something like mccarthyism be used as a partisan weapon against another political party? A metastasis (black arrow) shows homogenous arterial phase hyperenhancement with a peripheral hypointense rim in the hepatobiliary phase. 
Eur J Gastroenterol Hepatol 22:12531259, Vilgrain V, Lewin M, Vons C et al (1999) Hepatic nodules in BuddChiari syndrome: imaging features. [5,6,7] Nowadays, DWI has been widely used in Abdominal applications. 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. With ADC map, DWI can be qualitatively and quantitatively assessed and help for differentiating benign from malignant tumors in abdominal MRI examinations. The CT scan was done according to a standard protocol at 120140 kVp and 180300 mA at 2min per field of view, and a 3.75mm section thickness to match the PET section thickness.18F-FDG 3.70-5.55MBq/kg was administered intravenously according to body weight. Among 12 cases, 10 cases(83.3%)showed hypointensity on T2weighted imaging (Figs. Rarely, however, hepatic nodules may appear totally or J Am Coll Radiol 14:S314S325, de Ridder J, de Wilt JH, Simmer F et al (2016) Incidence and origin of histologically confirmed liver metastases: an explorative case-study of 23,154 patients. Cirrhosis: modified caudate-right lobe ratio. 3 The vast majority of MHLs are diagnosed before the first 5 years of life 3 and they are rarely seen in J Hepatol 47:658663, Thomeer MG, Willemssen FE, Biermann KK et al (2014) MRI features of inflammatory hepatocellular adenomas on hepatocyte phase imaging with liver-specific contrast agents. Bilateral temporal lobe T2 hyperintensity refers to hyperintense signal involving the temporal lobes on T2 weighted and FLAIR imaging. https://doi.org/10.1007/s00330-020-06687-y, Tsuboyama T, Onishi H, Kim T et al (2010) Hepatocellular carcinoma: hepatocyte-selective enhancement at gadoxetic acid-enhanced MR imagingcorrelation with expression of sinusoidal and canalicular transporters and bile accumulation. Br J Radiol. Gadoxetate disodium-enhanced MRI shows a focal nodular hyperplasia that is (a) nearly isointense to liver parenchyma in the precontrast T1-weighted sequence, (b) with marked hyperenhancement (arrow) in the arterial phase, (c) mildly hyperintense in the portal venous phase and (d) hyperintense in the hepatobiliary phase. A middle-aged male with no specific clinical symptoms was diagnosed with SANT. CD8 and CD86 positive expression was presented in 6 and 7 cases respectively. However occasionally they may appear hyperintense when compared to the background tissue. On the contrary, hypointensity would be blacker in color. However, the hepatobiliary phase (c) demonstrates a hyperintense rim establishing the diagnosis of FNH-like nodule. WebLesions were located in the left hepatic lobe in 13 cases, in the right lobe in 11, and in the caudate lobe in 2. PubMed Central The images or other third party material in this article are included in the articles Creative Commons licence, unless indicated otherwise in a credit line to the material. On T2WI, 10 cases(83.3%)showed hypointensity and 2 cases (16.7%) showed hyperintensity with central hypointensity. 1). AJR Am J Roentgenol 190:W290W293, Gevers TJG, Marcel Spanier BW, Veendrick PB, Vrolijk JM (2018) Regression of hepatocellular adenoma after bariatric surgery in severe obese patients. The lesions were biopsied Overall, its a non-invasive and painless method that provides a detailed and cross-sectional illustration of the internal organs. Thespoke-wheelpattern, considering as an typical imaging feature, had low sensitivity, which was presented in 5 cases (41.7%) in our study and 11 cases(48%) in a recent review study. PubMedGoogle Scholar. Kele PG, van der Jagt EJ. MRI scan is different from other diagnostic imaging techniques. Hyperenhancing metastases typically originate from primary neuroendocrine tumors, renal cell carcinoma, thyroid carcinoma, choriocarcinoma, and sarcomas. Unable to process the form. Hepatobiliary MRI contrast agents are increasingly being used for liver imaging. Staff Login Case 2: central tegmental tract T2 hyperintensity, see full revision history and disclosures, central tegmental tract T2 hyperintensity, symmetrical central nervous system lesions. The MRI hyperintensity reflects the existence of lesions in the brain. Gadoxetate disodium-enhanced MRI demonstrates a small HCC nodule (arrow) that (c) enhances in the hepatic arterial phase and (d) is hypointense in the hepatobiliary phase. AJR Am J Roentgenol 203:W408W414, Dioguardi Burgio M, Bruno O, Agnello F et al (2016) The cheating liver: imaging of focal steatosis and fatty sparing. Cerebral small vessel disease is an important cause of progressive cognitive impairment and a major contributor to vascular dementia ().Typically, the neuropathology features a combination of focal lacunar infarcts and more diffuse axonal loss, demyelination, and gliosis ().The coexistence of focal and diffuse abnormalities is reflected on It is a common imaging characteristic available in magnetic resonance imaging reports. Patients underwent at least one radiological examination before surgery. Feeling short of breath. 
A second metastasis (white arrow) shows peripheral rim enhancement with a peripheral hypointense rim and cloud-like central enhancement in the hepatobiliary phase. AJR Am J Roentgenol 211(2):347357, Grazioli L, Bondioni MP, Haradome H et al (2012) Hepatocellular adenoma and focal nodular hyperplasia: value of gadoxetic acid-enhanced MR imaging in differential diagnosis. The MRI imaging presents a range of sequences. Google Scholar, Spinazzi A, Lorusso V, Pirovano G, Kirchin M (1999) Safety, tolerance, biodistribution, and MR imaging enhancement of the liver with gadobenate dimeglumine: results of clinical pharmacologic and pilot imaging studies in nonpatient and patient volunteers. CAS [33] showed that FNH with hyperintense rim on HBP had fibrous tissue in the lesion center surrounded by some inflammation and vascular proliferation with ductular metaplasia, while the lesion periphery consisted mainly of well-differentiated preexistent bile ducts without signs of metaplasia, fibrous tissue, or inflammation; according to another theory, the reason for this different expression could be secondary to a different origin of the hepatocytes, with the ones surrounding the central scar of FNH originating from periportal venous hepatocytes and the ones in the peripheral portion from perivenular hepatocytes [29]. Abdom Radiol (NY) 44(10):33123324. In our study, 11(78.6%) of 14 cases were asymptomatic and the other 3 cases found the neoplasm occasionally or during the treatment of other diseases. Less commonly, hepatic lesions may show variable signal characteristics (Table 1) on HBP due to increased uptake of hepatobiliary contrast agents through OATP1B3 or to a delayed central enhancement secondary to retained contrast material by the fibrotic stroma (Fig.1) [7, 8]. Correspondence to Saline was injected at the same flow rate. You dont need to panic as most laboratories have advanced wide-bore MRI and open MRI machines. World J Gastroenterol. 2010;34(2):2069. [82] have also suggested that in patients with periportal hyperintensity in both HBP and T2-weighted images, the imaging finding indicates periportal edema which reflects the layer of loose connective tissue surrounding the portal veins expanded by inflammation or other conditions; consequently, periportal HBP hyperintensity could be considered as delayed enhancement of the periportal loose connective tissue in these patients. 
Among the HCCs showing hyperintensity on HBP, the pattern of hyperintensity may be homogeneous, mosaic or as nodule-in-nodule in 57%, 29% and 14% of the cases, respectively [38]. 20-ml saline was injected at the same flow rate. statement and A 55-year-old man with HCV-related cirrhosis and multiple HCCs. Chen, NX., Wang, ML., Wang, HX. Arterial phase hypervascular lesions include FNH, adenoma, HCC, and metastases from NET, melanoma, renal cell carcinoma, and (sometimes) breast cancer. [21] The SUVs in our study, however, were higher than the previous reports, with a SUV max of 4.5, 5.1 and 3.8 respectively. It is an accurate method of detecting and confirming the diagnosis. 2023 BioMed Central Ltd unless otherwise stated. The value of contrast-enhanced dynamic and diffusion-weighted MR imaging for distinguishing benign and malignant splenic masses. symmetric hyperintensities within the pons, substantia nigra, medulla, anterior horns of the spinal cord, and ventral nerve roots 3. . 34 Zhongshan Bei Road, Licheng District, Quanzhou, Fujian, China, Department of Radiology, Zhongshan Hospital, Fudan University, No. The cause for T2-weighted hypointensity may not be, however, always recognized, and only pathologic correlation may provide the answer. SANT was not expected to have FDG accumulation as a benign lesion. 2004;28(10):126879. This website also contains material copyrighted by 3rd parties. Cao P, Wang K, Wang C, Wang H. Sclerosing angiomatoid nodular transformation in the spleen: a case series study and literature review. The majority of liver lesions seen on MRI are hyperintense and thus, it's a nonspecific finding. A hepatologist or gastroenterologist should be consul Read More Created for people with ongoing healthcare needs but benefits everyone. It sounds: Much scarier than it likely is. You may have two small hepatomas which are generally watched. 
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