Nonhypervascular Hypoattenuating Nodules Depicted on Either Portal or Equilibrium Phase Multiphasic CT Images in the Cirrhotic Liver
Jae-Joon Chung1,
Jeong Sik Yu1,
Joo Hee Kim1,
Myeong-Jin Kim2 and
Ki Whang Kim2
1 Department of Radiology and Research Institute of Radiological Science,
Yongdong Severance Hospital, Yonsei University College of Medicine, 162,
Eonju-ro, Gangnam-gu, Seoul 135-720, Korea.
2 Department of Radiology and Research Institute of Radiological Science,
Severance Hospital, Yonsei University College of Medicine, 250, Seongsanno,
Seodaemun-gu, Seoul 120-752, Korea.
View larger version (93K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 1A —61-year-old woman with hepatitis B virus–related
macronodular liver cirrhosis. On initial equilibrium phase image of
multiphasic CT scan, 16-mm nonhypervascular hypoattenuating nodule
(arrow) is seen in segment V of liver.
|
|
View larger version (104K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 1B —61-year-old woman with hepatitis B virus–related
macronodular liver cirrhosis. On 27-month follow-up equilibrium phase CT
image, this nodule (arrow) grew to 33 mm in diameter without contrast
enhancement on arterial phase (not shown). This patient was treated by
radiofrequency ablation. Volume-doubling time of this nodule was 278 days;
 -fetoprotein level was slightly elevated from 5.8 to 14.8 ng/mL.
|
|
View larger version (68K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 2A —62-year-old woman with hepatitis B virus–related
macronodular liver cirrhosis. On initial equilibrium phase image of
multiphasic CT scan, 13-mm nonhypervascular hypoattenuating nodule
(arrow) is seen in dome of liver.
|
|
View larger version (70K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 2B —62-year-old woman with hepatitis B virus–related
macronodular liver cirrhosis. On 18-month follow-up arterial (B) and
equilibrium (C) phase CT images, this nodule (arrow, B)
shows no contrast enhancement and has grown up to 22 mm in diameter. Patient
was treated by radiofrequency ablation. Volume-doubling time of this nodule
was 252 days; -fetoprotein level was elevated from 5.6 to 20.5
ng/mL.
|
|
View larger version (79K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 2C —62-year-old woman with hepatitis B virus–related
macronodular liver cirrhosis. On 18-month follow-up arterial (B) and
equilibrium (C) phase CT images, this nodule (arrow, B)
shows no contrast enhancement and has grown up to 22 mm in diameter. Patient
was treated by radiofrequency ablation. Volume-doubling time of this nodule
was 252 days; -fetoprotein level was elevated from 5.6 to 20.5
ng/mL.
|
|
View larger version (81K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 3A —46-year-old man with hepatitis B virus–related
micronodular liver cirrhosis. On initial equilibrium phase image of
multiphasic CT scan, 12-mm nonhypervascular hypoattenuating nodule
(arrow) is seen in segment V of liver.
|
|
View larger version (94K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 3B —46-year-old man with hepatitis B virus–related
micronodular liver cirrhosis. On 38-month follow-up equilibrium phase CT
image, this nodule (arrow) shows no remarkable interval changes in
size, shape, or enhancement pattern.
|
|
View larger version (100K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 3C —46-year-old man with hepatitis B virus–related
micronodular liver cirrhosis. On follow-up arterial (C) and equilibrium
(D) phase CT images obtained 19 months after B, this nodule has
grown to 27 mm in diameter and shows prominent contrast enhancement on
arterial phase and washout of contrast material on equilibrium phase. Patient
was treated by transcatheter arterial chemoembolization. Volume-doubling time
of this nodule was 495 days; -fetoprotein level was slightly elevated
from 2.8 to 4.6 ng/mL.
|
|
View larger version (121K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 3D —46-year-old man with hepatitis B virus–related
micronodular liver cirrhosis. On follow-up arterial (C) and equilibrium
(D) phase CT images obtained 19 months after B, this nodule has
grown to 27 mm in diameter and shows prominent contrast enhancement on
arterial phase and washout of contrast material on equilibrium phase. Patient
was treated by transcatheter arterial chemoembolization. Volume-doubling time
of this nodule was 495 days; -fetoprotein level was slightly elevated
from 2.8 to 4.6 ng/mL.
|
|
View larger version (80K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 4A —61-year-old woman with hepatitis B virus–related
micronodular liver cirrhosis. On initial equilibrium phase image of
multiphasic CT scan, 13-mm nonhypervascular hypoattenuating nodule
(arrow) is seen in segment IV of liver.
|
|
View larger version (83K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 4B —61-year-old woman with hepatitis B virus–related
micronodular liver cirrhosis. At 26-month follow-up, unenhanced (B),
arterial (C), and equilibrium (D) phase CT images show that this
nodule has grown to 17 mm in diameter and has internal area of low density
(B), indicating fatty tissue by attenuation in Hounsfield units. This
nodule reveals contrast enhancement (arrows) on arterial phase
(C), including fatty tissue foci, isointense to surrounding liver
parenchyma and shows washout of contrast material on equilibrium phase
(D). Patient was treated by radiofrequency ablation. Volume-doubling
time of this nodule was 416 days; -fetoprotein level was slightly
elevated from 2.3 to 4.3 ng/mL.
|
|
View larger version (93K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 4C —61-year-old woman with hepatitis B virus–related
micronodular liver cirrhosis. At 26-month follow-up, unenhanced (B),
arterial (C), and equilibrium (D) phase CT images show that this
nodule has grown to 17 mm in diameter and has internal area of low density
(B), indicating fatty tissue by attenuation in Hounsfield units. This
nodule reveals contrast enhancement (arrows) on arterial phase
(C), including fatty tissue foci, isointense to surrounding liver
parenchyma and shows washout of contrast material on equilibrium phase
(D). Patient was treated by radiofrequency ablation. Volume-doubling
time of this nodule was 416 days; -fetoprotein level was slightly
elevated from 2.3 to 4.3 ng/mL.
|
|
View larger version (90K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 4D —61-year-old woman with hepatitis B virus–related
micronodular liver cirrhosis. At 26-month follow-up, unenhanced (B),
arterial (C), and equilibrium (D) phase CT images show that this
nodule has grown to 17 mm in diameter and has internal area of low density
(B), indicating fatty tissue by attenuation in Hounsfield units. This
nodule reveals contrast enhancement (arrows) on arterial phase
(C), including fatty tissue foci, isointense to surrounding liver
parenchyma and shows washout of contrast material on equilibrium phase
(D). Patient was treated by radiofrequency ablation. Volume-doubling
time of this nodule was 416 days; -fetoprotein level was slightly
elevated from 2.3 to 4.3 ng/mL.
|
|
View larger version (82K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 5A —52-year-old man with hepatitis B virus–related
micronodular liver cirrhosis. On initial equilibrium phase image of
multiphasic CT scan, 14-mm oval-shaped, nonhypervascular hypoattenuating
nodule (arrow) is seen in segment VII of liver.
|
|
View larger version (89K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 5B —52-year-old man with hepatitis B virus–related
micronodular liver cirrhosis. On 27-month follow-up equilibrium phase CT
image, this nodule (arrow) has grown up to 23 mm in diameter without
contrast enhancement on arterial phase of multiphasic CT scan.
|
|
View larger version (78K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 5C —52-year-old man with hepatitis B virus–related
micronodular liver cirrhosis. On follow-up arterial (C) and equilibrium
(D) phase CT images obtained 4 months after B, this nodule shows
focal contrast enhancement (arrow) in right posterolateral aspect of
nodule, suggesting nodule-in-nodule pattern, on arterial phase (C) and
has grown up to 27 mm in diameter with washout of contrast material
(arrow) on equilibrium phase (D). Patient was treated by
transcatheter arterial chemoembolization. Volume-doubling time of this nodule
was 479 days; -fetoprotein level was elevated from 40.1 to 61.5
ng/mL.
|
|
View larger version (93K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 5D —52-year-old man with hepatitis B virus–related
micronodular liver cirrhosis. On follow-up arterial (C) and equilibrium
(D) phase CT images obtained 4 months after B, this nodule shows
focal contrast enhancement (arrow) in right posterolateral aspect of
nodule, suggesting nodule-in-nodule pattern, on arterial phase (C) and
has grown up to 27 mm in diameter with washout of contrast material
(arrow) on equilibrium phase (D). Patient was treated by
transcatheter arterial chemoembolization. Volume-doubling time of this nodule
was 479 days; -fetoprotein level was elevated from 40.1 to 61.5
ng/mL.
|
|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Copyright © 2008 by the American Roentgen Ray Society.
