74 Hyper enhancing Focal Liver Lesions

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GI 74-1 Hepatocellular carcinoma. (A) Noncontrast scan shows the lesion (H) as an ill-defined, low-attenuation mass. (B) Scan during peak arterial contrast shows striking enhancement throughout the mass.133

• Fig GI 74-2 Hemangioma. Arterial phase scan reveals a small homogeneous, hypervascular nodule, which remained homogeneously hyperdense during the portal vein phase (not shown).134

• Fig GI 74-3 Focal nodular hyperplasia. (A) On the nonenhanced scan, it is very difficult to detect the lesion in the medial segment of the left hepatic lobe. (B) On the early contrast scan, the lesion is uniformly enhanced and well defined. Note the small central stellate scar (open arrow).135

• Fig GI 74-4 Hepatocellular adenoma. Early contrast scan shows marked diffuse enhancement of the lesion (arrows).133

• Fig GI 74-5 Metastasis. Enhancing mass (curved arrow) in the right hepatic lobe that is especially clear against the background of a diffuse fatty liver.135

• Fig GI 74-6 Hemangioma. (A) Portal vein-phase scan shows globular hyperenhancing areas in the periphery of the large lesion (arrowheads). (B) During the equilibrium phase, there is progressive peripheral pooling of contrast material.134

• Fig GI 74-7 Hepatocellular carcinoma. Portal vein-phase study shows the hypervascular tumor with mosaic pattern (arrow).134

• Fig GI 74-8 Focal nodular hyperplasia. Homogeneous enhancement during the portal vein phase. The lesion appears hyperdense because of the background of fatty liver parenchyma.134

• Fig GI 74-9 Solitary fibrous liver tumor. (A) Portal vein-phase scan shows heterogeneous areas of enhancement. (B) In the equilibrium phase, there is striking hyperenhancement of the lesion.134

• Fig GI 74-10 “Hot-spot” lesion. Geographic hyperenhancing lesion at the dome of the liver (arrow) in this patient with Hodgkin's lymphoma and superior vena cava thrombosis.134