Fabre et al developed radiologic criteria for the diagnosis of focal nodular hyperplasia (FNH). This should be used in conjunction with biopsy findings and clinical features. The authors are from Hopital Beaujon in Clichy, France.
Patient selection: one or more liver mass
Radiologic finding seen with FNH:
(1) hypervascularity
(2) homogeneity
(3) nonencapsulated
(4) central scar
Imaging
Typical Central Scar
MRI
hypotense on T1-weighted images; hyperintense on T2-weight images; enhanced on delayed T1-postgadolinium sequences
CT
hypodense on unenhanced images; enhanced in delayed post-contrast images
Nonclassical forms of FNH include:
(1) telangiectatic
(2) mixed hyperplastic-adenomatous
(3) with cytologic atypia
number of radiologic findings =
= SUM(number of findings identified)
Interpretation:
• minimum number of imaging findings: 0
• maximum number of imaging findings: 4
• In the series of Fabre et al most cases had 0 to 2 of the imaging findings.
• The absence of central scar occurs in "nonclassical" FNH and can make diagnosis more challenging.
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