Hemodynamic Characterization of Focal Nodular Hyperplasia Using Three-Dimensional Volume-Rendered Multidetector CT Angiography
Giuseppe Brancatelli1,2,
Michael P. Federle1,
Sanjeev Katyal1 and
Vibhu Kapoor1
1 Department of Radiology, Division of Abdominal Imaging, University of
Pittsburgh Medical Center, 200 Lothrop St., Pittsburgh, PA 15213.
2 Present address: Department of Radiology, University of Palermo, Italy.
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Fig. 1A. —39-year-old woman with focal nodular hyperplasia. Early
hepatic arterial phase transverse CT scan (20-sec delay) shows large
homogeneously and brightly enhancing mass (solid straight arrow) with
central scar (open arrow). Blood vessels (curved arrows) are
evident within mass and on its surface, but their origin and course are
difficult to determine.
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Fig. 1B. —39-year-old woman with focal nodular hyperplasia. Portal
venous phase transverse CT scan (70-sec delay) reveals blood vessels
(arrows), probably veins, within mass and on its surface. Mass is
nearly isoattenuating to liver.
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Fig. 1C. —39-year-old woman with focal nodular hyperplasia.
Volume-rendered CT angiogram (20-sec delay) shows focal nodular hyperplasia
(FNH) lesion supplied by anomalous artery (a a) arising from hepatic artery
(HA). Lesion is drained by two hepatic vein tributaries (HV).
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Fig. 2A. —45-year-old woman with focal nodular hyperplasia. Early
arterial phase transverse CT scan (13-sec delay) shows lesion (straight
arrow) is brightly and homogeneously enhancing. Blood vessels (curved
arrow) are noted on surface of mass.
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Fig. 2B. —45-year-old woman with focal nodular hyperplasia. Portal
venous phase CT scan (60-sec delay) shows mass almost isoattenuating to liver
with hypoattenuating central scar (open arrow). Large blood vessels
(solid arrows) are noted.
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Fig. 2C. —45-year-old woman with focal nodular hyperplasia.
Volume-rendered CT angiogram (13-sec delay) shows multiple branches of
anomalous artery (a a) spread over lesionlike spider legs. HA = hepatic
artery, FNH = focal nodular hyperplasia.
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Fig. 2D. —45-year-old woman with focal nodular hyperplasia.
Volume-rendered CT angiogram (60-sec delay) shows that multiple draining veins
(arrows) coalesce to drain into right hepatic vein (RHV) and inferior
vena cava (IVC).
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Fig. 3. —43-year-old woman with focal nodular hyperplasia.
Volume-rendered CT angiogram (20-sec delay) shows large focal nodular
hyperplasia lesion (FNH) supplied by multiple branches of anomalous artery (a
a) arising from hepatic artery (HA). Small lesion (FNH) is supplied by single
artery.
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Fig. 4A. —70-year-old woman with cirrhosis and hepatocellular
carcinoma. Portal venous phase transverse CT scan shows 5-cm hypoattenuating
lesion in segment VIII of liver.
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Fig. 4B. —70-year-old woman with cirrhosis and hepatocellular
carcinoma. Maximum-intensity-projection off-axial CT scan shows two enhancing
vessels (straight arrows) at periphery of mass draining lesion and
joining right branch of portal vein (curved arrow). On biopsy, mass
was well-differentiated hepatocellular carcinoma.
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Copyright © 2002 by the American Roentgen Ray Society.
