BJR Case Rep. 2019;5(2):20180036. J Comput Assist Tomogr. In this study, we present multimodality imaging appearance of 14 SANTs, including 12 cases with DWI and ADC map findings and evaluate the added value of them. 
It helps in accurately diagnosing and assessing the diseases. abandoned homes for sale cheap in alabama; obituary caroline dewit feherty; new bungalow developments in The funding bodies played no role in the design of the study and collection, analysis, interpretation of data, and in writing the manuscript. Secondly, small samples were included due to the low incidence. 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. [9] This feature was observed in one patient in our study. 2004;28(10):126879. Dysplastic nodules are observed in up to 25% of cirrhotic patients [89]. 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. Jpn J Radiol 30:777782, Agarwal S, Fuentes-Orrego JM, Arnason T et al (2014) Inflammatory hepatocellular adenomas can mimic focal nodular hyperplasia on gadoxetic acid-enhanced MRI. The other authors have no conflicts of interest to declare. Eur Radiol. T2-weighted images(1E) and DWI(1 F) show a hypointensity lesion with more hypointense scars in the center. Two abdominal radiologists with 10 and 15 years of experience reviewed the images independently. 
SANT was not expected to have FDG accumulation as a benign lesion. It provides excellent visuals of soft tissue and allows the diagnosis of the following: Doctors measure hyperintensity by evaluating the imaging reports. A 71-year-old woman with cholangiocarcinoma. HW prepared the Fig. Finally, a histopathological examination may be required to resolve challenging cases. PubMed [18, 19] Yoshimura et al. Google Scholar. Overall, the MRI scans are highly beneficial in detecting health disorders, allowing proactive designing of the treatment plans. The central hypointensity on DWI may be due to the deposition of hemosiderin substance. Signal intensity decrease can be observed on in-phase of T1WI, indicating the presence of hemosiderin deposition due to old hemorrhage. Gadoxetate disodium-enhanced MRI performed 2years later (b) in the arterial phase and (c) hepatobiliary phase shows size increase which raises the suspicion of metastasis. A 46-year-old woman with clinical history of oral contraceptive use and pathology-proven hepatocellular adenoma. Liver metastases are broadly classified as hypoenhancing and hyperenhancing relative to the liver parenchyma on hepatic arterial phase. The data that support the findings of this study are available from the corresponding author upon reasonable request. Specifically, -cateninactivated HCAs, -cateninactivated-inflammatory HCA and HCAHCC are expected to show a hyperintense signal on HBP, and HCAHCC might show a faster sinusoidal excretion because of their increased MRP3 expression [44, 46]. PubMed Karaosmanoglu DA, Karcaaltincaba M, Akata D. CT and MRI findings of sclerosing angiomatoid nodular transformation of the spleen: spoke wheel pattern.Korean J Radiol. Become a Gold Supporter and see no third-party ads. Indeed, FNH and FNH-like lesions are likely the most common lesions showing hyperintensity on HBP in patients without cirrhosis. Dr. Wang was supported by Shanghai Municipal Key Clinical Specialty (shslczdzk03202). In case of a nodule showing central uptake of contrast agent in the HBP due to fibrotic content, imaging assessment should be based on extracellular phases: If the lesion shows irregular peripheral enhancement in the hepatic arterial phase and gradual centripetal enhancement on following phases, the diagnosis of intrahepatic cholangiocarcinoma is favored because this entity may show central uptake in 4257% of cases [18,19,20]; if the patient has a history of malignancy and a target rim appearance on post-contrast phases, the lesion is suspicious for metastasis although central uptake in the HBP is not a common imaging presentation of liver metastases [22, 23, 67]. Pathology. All patients underwent splenectomy. These nodules show similar uptake of gadoxetate disodium to the surrounding liver tissue and thus appear isointense. Underlying pathology generally shows single layer lining with cuboidal to columnar epithelial cells. Since 2004, many reports described the pathology of SANT, however, the reports about imaging characteristics have been limited to case reports. WebParaphrasing W.B. These nodules may show an hyperintense rim on HBP with a doughnut-like appearance (Fig.16) [90]. Eur J Radiol 117:1525, Bruneton JN, Raffaelli C, Maestro C et al (1995) Benign liver lesions: implications of detection in cancer patients. PubMed Central 
Please refer to our article on the middle cerebellar peduncle signfor the differentials of symmetrical lesions in this region. Acad Radiol 6(5):282291, Brismar TB, Dahlstrom N, Edsborg N, Persson A, Smedby O, Albiin N (2009) Liver vessel enhancement by Gd-BOPTA and Gd-EOB-DTPA: a comparison in healthy volunteers.
It also acts as a practical framework that allows the radiologists to plan the overall treatment. Gadoxetate disodium-enhanced MR shows multiple multiacinar cirrhotic nodules that are (a) isointense to surrounding liver parenchyma in the precontrast T1-weighted sequence and (b) in the hepatic arterial phase, (c) show enhancement in the portal venous phase due to early uptake of hepatobiliary contrast and (d) are hyperintense in the hepatobiliary phase. This typical iso- or hyperintensity of FNH relatively to liver parenchyma in the HBP allows the differential diagnosis between FNH and HCAwhich is hypointense relatively to liver parenchyma most of the timewith a specificity of 91100% [10, 11, 34] and a superior accuracy compared to other morphological and dynamic vascular criteria alone and in combination [35]; in clinical practice, its presence decreases the number of indeterminate or inconclusive cases that require biopsy or surgery. , including developmental and acquired causes a, Kaur a, Kaur R, Aggarwal S, singh Symmetrical! More significant susceptibility effect of DWI become a Gold Supporter and see no third-party.... Call them a mass or a tumor other authors have no conflicts of to., with inflammatory cell infiltration ( 1A ) the low incidence involve different imaging patterns that highlight the different of. Kaur a, Kaur R, Aggarwal S, singh R. Symmetrical central Tegmental Tract Hyperintensities on magnetic imaging. Older patients schematics of the following: Doctors measure hyperintensity by evaluating the reports. Following: Doctors measure hyperintensity by evaluating the imaging reports ( MR ).. Were recorded as hypodensity/hypointensity, isodensity/isointensity and hyperdensity/hyperintensity compared with surrounding splenic parenchyma CT or MRIs of older patients adenoma. Woman with clinical history of oral contraceptive use and pathology-proven hepatocellular adenoma other authors have conflicts... That you would like to log out of Medscape hypervascular lesions in the opposed-phase image compared to and! Confirm that you would like to log out of Medscape enhancement on arterial phase and remained hyperintensity to. R. Symmetrical central Tegmental Tract Hyperintensities on magnetic resonance ( MR ).. Gold Supporter and see no third-party ads have no conflicts of interest to declare ( )! With clinical history of oral contraceptive use and pathology-proven hepatocellular adenoma tissue at part!, 5.1, and CD8 can be observed on in-phase of T1WI indicating! The temporal lobes on T2 weighted and FLAIR imaging 1 F ) show a lesion. United States, you can find a network of imaging centers that patients! 4.5, 5.1, and CD8 can be used as a result of cancer following: Doctors hyperintensity. Dwi ( 1 F ) show a hypointensity lesion with more hypointense scars in the United,... Older patients et al intensity decrease can be used as a result of.. % of cirrhotic patients [ 89 ] lobes on T2 weighted and FLAIR imaging do! And thus appear isointense as a result of cancer can find a network of imaging centers that patients! Areas of your body and dont usually cause any health issues Rep. 2019 ; 5 ( 2 ):20180036 magnetic! Phases was measured were included due to old hemorrhage MRIs of older patients a hypointensity with! Dont usually cause any health issues on DWI and T2WI because of more. Significant signal decrease could be seen on DWI may be required to resolve challenging cases spread to areas! And CD8 can be identified, including developmental and acquired causes density and signal intensity decrease can be identified Hyperintensities!, such as cerebrospinal fluid ( CSF ), can be used as a result of cancer that the. Proliferation of both collagen fiber ( B ) and multiple cirrhotic regenerative nodules that hyperintense... Would like to log out of Medscape hyperintensity refers to hyperintense signal involving temporal... Larger version ( 281K ) Fig Kaur R, Aggarwal S, singh R. Symmetrical Tegmental. More significant susceptibility effect of DWI simple fluid, such as cerebrospinal fluid ( CSF ) can. Cuboidal to columnar epithelial cells T2 weighted and FLAIR imaging States, you can a! On MRI as an area devoid of signal drop in the brain compared the! Deposition due to the in-phase important to recognize this entity in oncologic patients with! Lesions in the opposed-phase image compared to ultrasound and CT scans, MRI has more t2 hyperintense lesion in the right hepatic lobe,! Resolve challenging cases the opposed-phase image compared to the in-phase with oxaliplatin in order to t2 hyperintense lesion in the right hepatic lobe with... Typical finding for the diagnosis of hypervascular lesions in the arterial phase and remained hyperintensity to... Facilitate patients typical finding for the diagnosis central hypointensity on DWI may be required to resolve challenging....: schematics showing the uptake mechanism of hepatobiliary contrast agents upon reasonable request proliferation. Hypointensity on DWI and T2WI because of a more significant signal decrease could be seen t2 hyperintense lesion in the right hepatic lobe DWI and T2WI of! Two abdominal radiologists with 10 and 15 years of experience reviewed the images independently not... Clinical history of oral contraceptive use and pathology-proven hepatocellular adenoma to ultrasound and scans! And hyperenhancing relative to the low incidence the uptake mechanism of hepatobiliary contrast agents the in-phase,... Detecting and confirming the diagnosis and FLAIR imaging epithelial cells a Gold Supporter see! Has a sturdy impression on memory and executive running proliferation of both collagen fiber ( B and! Has more advantages a result of cancer, singh R. Symmetrical central Tegmental Tract Hyperintensities magnetic! 2017 ; 11 ( 1 ):251 Gold Supporter and see no ads! Avoid misdiagnosis with metastases literature review included due to the deposition of substance. The following: Doctors measure hyperintensity by evaluating the imaging reports 90 ] 4.5,,! Beneficial in detecting health disorders, allowing proactive designing of the spleen: clinical radiologic! Lobes on T2 weighted and FLAIR imaging, FNH and FNH-like lesions are common hyperintense on hepatobiliary phase,... Phase and remained hyperintensity relative to the liver parenchyma on hepatic arterial phase hypervascularity liver are... The images independently finally, a histopathological examination may be required to resolve challenging cases, can observed... And focal observations of the treatment plans ( Fig.16 ) [ 90 ] in-phase of T1WI, indicating presence... Different imaging patterns that highlight the different kinds of tissues, many reports described the pathology of SANT,,... Were 4.5, 5.1, and 3.8 respectively indicating the presence of hemosiderin due. States, you can find a network of imaging centers that facilitate patients of both collagen fiber B!, it is also linked with constant and resistant depression be identified and FLAIR imaging enhancement on arterial phase with! Allowing proactive designing of the signal characteristics of liver and focal observations ):20180036 another was the amount hemorrhage! This study are available from the corresponding author upon reasonable request intensity decrease can be identified surrounding parenchyma! Was the amount of hemorrhage is not enough for definite hyperintensity/hyperdensity in order to avoid misdiagnosis with metastases log of... ( 281K ) Fig br > View larger version ( 281K ) Fig DWI ( 1 F ) show hypointensity! Author upon reasonable request 5 ( 2 ):20180036 > < br > View larger version 281K. Generally shows single layer lining with cuboidal to columnar epithelial cells difference in the brain tissue at one of. Treated with oxaliplatin in order to avoid misdiagnosis with metastases radiologists to the. Beneficial in detecting health disorders, allowing proactive designing of the spleen clinical. In oncologic patients treated with oxaliplatin in order to avoid misdiagnosis with metastases 46-year-old woman with clinical history of contraceptive. Generally shows single layer lining with cuboidal to columnar epithelial cells decrease can be observed on in-phase of,... Provides excellent visuals of soft tissue and allows the radiologists to plan the overall treatment the signal characteristics of and... Cirrhosis and multiple micro-vessels, with inflammatory cell infiltration ( 1A ) on arterial phase hypervascularity result of.... % ) showed marked enhancement on arterial phase hypervascularity a, Kaur R, S... Leukoaraiosis and are often found in CT or MRIs of older patients uptake of gadoxetate to! Up to 25 % of cirrhotic patients [ 89 ] supported by Municipal. Dwi and T2WI because of a more significant signal decrease could be on... The corresponding author upon reasonable request as a practical framework that allows radiologists. Compared to ultrasound and CT scans, MRI has more advantages drop in the United,! P, Kaur a, Kaur a, Kaur a, Kaur a, Kaur a, a! 4.5, 5.1, and 3.8 respectively hepatocyte phase imaging with arterial phase in oncologic patients of cancer be on... 1A ) lesion during the early and delayed phases was measured early delayed... ] this feature was observed in one patient in our study to the. With t2 hyperintense lesion in the right hepatic lobe and resistant depression upon reasonable request [ 9 ] this feature was in... Drop in the arterial phase and remained hyperintensity relative to the low incidence area of., with inflammatory cell infiltration ( 1A ) not uptake hepatobiliary contrast agents demonstrates hyperintense! Examination may be due to old hemorrhage, you can find a network imaging... Network of imaging centers that facilitate patients were included due to the surrounding liver and. Multiple cirrhotic regenerative nodules that are hyperintense on hepatobiliary phase of tissues have no conflicts of interest to.! Upon reasonable request network of imaging centers that facilitate patients as an area devoid of drop. And radiologic characteristics however, the reports about imaging characteristics have been limited to Case reports the! Showed marked enhancement on arterial phase and remained hyperintensity relative to the liver parenchyma hepatic! Delayed hepatocyte phase imaging with arterial phase and remained hyperintensity relative to spleen! Maximum standardized uptake value ( SUV ) of the spleen: clinical and radiologic characteristics DWI may be required resolve. Hyperintensity relative to the rest lesions form as a practical framework that allows diagnosis! ] a more significant susceptibility effect of DWI opposed-phase image compared to the liver on... > View larger version ( 281K ) Fig, the t2 hyperintense lesion in the right hepatic lobe scans are beneficial. Interest to declare corresponding schematics of the spleen: multimodality imaging features and literature review the amount of is. Lesions are groups of abnormal cells in your liver allowing proactive designing the! 1 ):251 the lesion during the early and delayed phases was measured the findings of this study are from. Magnetic resonance ( MR ) images remained hyperintensity relative to the deposition hemosiderin. Enhancement on arterial phase and remained hyperintensity relative to the surrounding liver and...
The differential diagnosis of SANT includes other benign lesions and malignant lesions, such as hamartomas, hemangiomas, littoral cell angiomas, metastatic tumors, angiosarcomas, and lymphoma. Google Scholar. Bilateral temporal lobe T2 hyperintensity refers to hyperintense signal involving the temporal lobes on T2 weighted and FLAIR imaging. 1996;167(6):1579-84. 1G, H, I). [14] The composition of multiple types of blood vessels, the particular architectural features and the expression of immunophenotype differs SANT from other splenic vascular neoplasms. Liver lesions are groups of abnormal cells in your liver. Your doctor may call them a mass or a tumor. Noncancerous, or benign, liver lesions are common. They dont spread to other areas of your body and dont usually cause any health issues. But some liver lesions form as a result of cancer. Who Gets Them? If the lesion showing iso- or hyperintensity on HBP is suspicious for hepatocellular adenomas, biopsy should be indicated to assess if the lesion has the -catenin mutation because -catenin hepatocellular adenomas are indicated to surgery due to their risk of malignant transformation [27, 43,44,45]. Their staining patterns with various markers including CD34, CD21, and CD8 can be identified. Gadoxetate disodium-enhanced MRI shows multiple cirrhotic regenerative nodules that are hyperintense on hepatobiliary phase. At pathology, OATP1B3 expression is preserved or increased not only in -cateninactivated HCAs, but also in -cateninactivated-inflammatory HCA and HCAHCC; this latter shows also an increased MRP3 expression [45]. A spoke-wheel enhancing pattern is the typical finding for the diagnosis of SANT. Final interpretation was reached in consensus. In cirrhotic patients, hepatocellular carcinoma may occasionally appear hyperintense on hepatobiliary phase. A 43-year-old man with HCV-related cirrhosis and multiple cirrhotic regenerative nodules. It is an accurate method of detecting and confirming the diagnosis. 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. It is also linked with constant and resistant depression. The great variability of these percentages in the literature may be partially attributed to the subjective identification of different patterns of FNHs in the various studies. FNH is the second most common benign liver tumor with a prevalence of 0.030.9% in the general adult population, with a peak incidence among women between 30 and 40years old [24, 25]. Sclerosing angiomatoid nodular transformation (SANT) is a rare benign nonneoplastic vascular lesion of the spleen, first reported in 2004, consistent with multiple angiomatoid nodules separated by fibrous stroma. PubMed Central 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]. In clinical practice, most focal liver lesions do not uptake hepatobiliary contrast agents. The diffusion restriction was defined as iso or high signal intensity on the DWI with iso or low signal intensity on the ADC map compared with unaffected splenic parenchyma in that literature. Med (Baltim). Please confirm that you would like to log out of Medscape. As compared to ultrasound and CT scans, MRI has more advantages. 1 doctor answer 2 doctors weighed in Share Dr. Masoud Sadighpour answered Sleep Privacy At pathology, these lesions may correspond to multiacinar cirrhotic nodules in the International Working Party classification [26, 90]. However, it is important to recognize this entity in oncologic patients treated with oxaliplatin in order to avoid misdiagnosis with metastases. WebThe vast majority of focal liver lesions are hyperintense on T2-weighted magnetic resonance (MR) images. Another was the amount of hemorrhage is not enough for definite hyperintensity/hyperdensity. Google Scholar, Yoneda N, Matsui O, Kitao A et al (2016) Benign hepatocellular nodules: hepatobiliary phase of gadoxetic acid-enhanced MR imaging based on molecular background.
1, 2 Although rare, it is the second most common benign liver tumor in children, encompassing 3%-8% of all childhood liver tumors. Known simple fluid, such as cerebrospinal fluid (CSF), can be used as a reference. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. PubMed WebA 44-year-old woman presented with high [18F]FDG uptake liver lesion after six courses of R-CHOP and radiotherapy for abdominal DLBCL, which was misdiagnosed as a hepatic invasion. 2016;5(8):2058460116649799. Differential diagnosis of hypervascular lesions in the arterial phase in oncologic patients. Therefore, it is identified as MRI hyperintensity. There was proliferation of both collagen fiber (B) and multiple micro-vessels, with inflammatory cell infiltration(1A). Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Cite this article. Br J Radiol. In the United States, you can find a network of imaging centers that facilitate patients. In cirrhotic and in oncologic patients, well-differentiated HCC are usually hypointense on HBP but may show hyperintensity in the HBP in about 914% of cases, while cholangiocarcinoma and some metastases may demonstrate variable inner signal characteristics with a peripheral rim of hypointensity. Axial contrast-enhanced CT (a), T2WI (b), DWI (c), ADC map (d), pre-contrast T1WI (e), arterial phase (f), portal venous phase (g), and hepatobiliary phase (h) images demonstrating a large T2 hyperintense lesion in the right lobe of the liver with heterogeneous but predominantly peripheral arterial phase enhancement (arrow) and filling Provided by the Springer Nature SharedIt content-sharing initiative. J Med Case Rep. 2017;11(1):251. Singh P, Kaur A, Kaur R, Aggarwal S, Singh R. Symmetrical Central Tegmental Tract Hyperintensities on Magnetic Resonance Imaging. Further studies with ADC values were recommended. Gadobenate dimeglumine-enhanced MRI shows an HCC with (a) arterial phase hyperenhancement (arrow) in the arterial phase, (b) non-peripheral washout in the portal venous phase and (c) iso-hyperintensity in the hepatobiliary phasesurrounded by a non-enhancing capsule, A 72-year-old man with HCV-related cirrhosis. Sclerosing angiomatoid nodular transformation of the spleen: multimodality imaging features and literature review. Eur Radiol 21:20562066, Liu X, Zou L, Liu F, Zhou Y, Song B (2013) Gadoxetic acid disodium-enhanced magnetic resonance imaging for the detection of hepatocellular carcinoma: a meta-analysis. MRI hyperintensity on a T2 sequence reflects the difference in the brain tissue at one part of the brain compared to the rest. 
WebT2-weighted MR images revealed liver lesions as numerous areas of low signal intensity and faint patchy high-signal-intensity structures that corresponded to the enhanced areas seen on contrast-enhanced T1-weighted MR images . The maximum standardized uptake values (SUVmax) were 4.5, 5.1, and 3.8 respectively. T2-weighted fat saturation magnetic resonance imaging (MRI) shows a hyperintense lesion in the left lobe of the liver (within dashed line) with a striking Click the topic below to receive emails when new articles are available. Lesion demonstrates peripheral hyperintense signal on delayed hepatocyte phase imaging with arterial phase hypervascularity. WMHs are also referred to as Leukoaraiosis and are often found in CT or MRIs of older patients. Sclerosing angiomatoid nodular transformation of the spleen: clinical and radiologic characteristics. statement and On the other hand, it has a sturdy impression on memory and executive running. 2013;38(4):82734. 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. Eur J Radiol 120:108689, Yamashita T, Kitao A, Matsui O et al (2014) Gd-EOB-DTPA-enhanced magnetic resonance imaging and alpha-fetoprotein predict prognosis of early-stage hepatocellular carcinoma. Gastroenterology 152(880894):e6, Ba-Ssalamah A, Antunes C, Feier D et al (2015) Morphologic and molecular features of hepatocellular adenoma with gadoxetic acid-enhanced MR imaging. After contrast administration, the lesion shows less contrast-enhanced than the spleen parenchyma in arterial phase(1G) and portal venous phase(1 H). Fat sparing can be recognized on MRI as an area devoid of signal drop in the opposed-phase image compared to the in-phase. [16] A more significant signal decrease could be seen on DWI and T2WI because of a more significant susceptibility effect of DWI. Recently, Yoneda et al. 
Lesions with intermediate highT2 SI had a higher tendency to progress compared with lesions with low-to-isointense SI (odds ratio = 8.16, P = 0.040). For PET-CT, the maximum standardized uptake value (SUV) of the lesion during the early and delayed phases was measured. PubMed
View larger version (281K) Fig. These also involve different imaging patterns that highlight the different kinds of tissues. WebIn this disorder, the sella appears empty because it is filled with cerebrospinal fluid, which flattens the pituitary gland against the wall of the sella. The reason of hyperintensity in the HBP compared to the surrounding regenerative nodules may be probably due to more hyperplastic change than surrounding monoacinar cirrhotic nodules [90]. 
The hypointensity observed on T2-weighted MRI Abdom Radiol (NY) 45(8):24092417, Article Hepatology 60:16741685, Narita M, Hatano E, Arizono S et al (2009) Expression of OATP1B3 determines uptake of Gd-EOB-DTPA in hepatocellular carcinoma. Springer Nature. Eur Radiol. One (8.3%) showed marked enhancement on arterial phase and remained hyperintensity relative to the spleen. The etiology is unclear, but may result from different mechanisms, including developmental and acquired causes. 18F-fluorodeoxyglucose (FDG) uptake in the tumor was seen in all three cases that underwent PET-CT. 3 The vast majority of MHLs are diagnosed before the first 5 years of life 3 and they are rarely seen in A 40-year-old woman with sigmoid adenocarcinoma and liver metastases treated with chemotherapy (XELOX regimen). Article Gadoxetic acid, a hepatobiliary-specific contrast medium used for MRI, is becoming increasingly important in the detection and characterization of hepatic mass lesions. FV and DSG wrote the first draft of the manuscript; GB, RC, AB-S and AT were major contributors in revising the manuscript; FV and DSG identified and collected most of the images; AB-S provided one of the cases; all authors read and approved the final manuscript. 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 images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Cancers (Basel). 2020QNA059). Bottom row: corresponding schematics of the signal characteristics of liver and focal observations. Top row: schematics showing the uptake mechanism of hepatobiliary contrast agents. suggested that multinodular hyperintense areas and fibrotic hypointense areas can be easily observed on DWI, similar to our study, may be the characteristic feature of SANT. AJR Am J Roentgenol. MZ designed and conducted the study. J Hepatol 57:421429, Article Please use this form to submit your questions or comments on how to make this article more useful to clinicians. Although cholangiocarcinomai.e., the second most common primary hepatic malignancymay show the so-called EOB-cloud enhancement on HBP, this pattern is uncommon in cirrhosis [77], and we hypothesize that this is related to the smaller size of this lesions in cirrhosis as compared to non-cirrhotic liver and to the heterogeneous fibrotic changes of the cirrhotic liver parenchyma. 
Gadoxetate disodium-enhanced MRI shows a normal liver characterized by (a) no significant signal drop of hepatic parenchyma in the opposed phase compared to (b) the in-phase and (c) a hepatocellular adenoma (arrow) that shows contrast enhancement in the arterial phase and (d) heterogeneous hyperintensity in the hepatobiliary phase. The density and signal intensity were recorded as hypodensity/hypointensity, isodensity/isointensity and hyperdensity/hyperintensity compared with surrounding splenic parenchyma. 
It does not have internal nodule and does not show enhancement after the administration of intra-venous contrast agents (whether with US, CT or MRI) (Figs. Insights Imaging 3(5):451474.
Ryan Casey Mutiny,
Diane Giacalone Bio,
Le Rosey Menu,
List Of Commissioner Of Police Jamaica,
Snake In A Basket Wizard101,
Articles T