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Published online before print June 20, 2003, 10.1148/radiol.2282020040
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(Radiology 2003;228:465-472.)
© RSNA, 2003

Gastrointestinal Imaging

Telangiectatic Focal Nodular Hyperplasia: US, CT, and MR Imaging Findings with Histopathologic Correlation in 13 Cases1

Patrick Attal, MD, Valérie Vilgrain, MD, Giuseppe Brancatelli, MD, Valérie Paradis, MD, Benoît Terris, MD, Jacques Belghiti, MD, Bachir Taouli, MD and Yves Menu, MD

1 From the Departments of Radiology (P.A., V.V., G.B., B. Taouli, Y.M.), Pathology (V.P., B. Terris), and Digestive Surgery and Transplantation Unit (J.B.), Hopital Beaujon, Clichy, France. From the 1999 RSNA scientific assembly. Received February 12, 2002; revision requested April 10; final revision received November 17; accepted December 16. Address correspondence to G.B., Department of Radiology, University of Palermo, via Villaermosa 29, 90139 Palermo, Italy (e-mail: gbranca@yahoo.com).

PURPOSE: To review the ultrasonographic (US), computed tomographic (CT), and magnetic resonance (MR) imaging findings in 13 patients with telangiectatic focal nodular hyperplasia (FNH) and to compare imaging features with histopathologic results from resected specimens.

MATERIALS AND METHODS: US, helical multiphasic CT, and MR images in 13 patients with pathologically proven telangiectatic FNH were reviewed retrospectively. Two abdominal radiologists evaluated lesions for number, size, heterogeneity, surface characteristics, presence of a central scar, presence of a pseudocapsule, US appearance, attenuation at CT, signal intensity at MR imaging, and presence of associated lesions. Imaging and pathologic findings were compared.

RESULTS: Sixty-one lesions (5–140 mm in diameter) were seen at imaging. Lesions were multiple in eight of 13 (62%) patients. Imaging characteristics were heterogeneity in 26 of 61 lesions (43%), well-defined margins in 43 of 61 (70%), lack of a central scar in 56 of 61 (92%), presence of a pseudocapsule in three of 61 (5%), hyperintensity on T1-weighted MR images in 17 of 32 (53%), strong hyperintensity on T2-weighted MR images in 24 of 54 (44%), and persistent enhancement on delayed contrast material–enhanced CT or T1-weighted MR images in 23 of 38 (61%). No specific US pattern was noted. Two patients had additional lesions: One had classic FNH, and the other had a cavernous hemangioma. Hyperintensity on T1-weighted MR images was due to sinusoidal dilatation. Hyperintensity on T2-weighted MR images correlated well with the presence of inflammation.

CONCLUSION: Telangiectatic FNH differs from typical FNH at imaging: Atypical FNH features often observed with telangiectatic FNH are lack of a central scar, lesion heterogeneity, hyperintensity on T1-weighted MR images, strong hyperintensity on T2-weighted MR images, and persistent contrast enhancement on delayed contrast-enhanced CT or T1-weighted MR images.

© RSNA, 2003

Index terms: Liver, focal nodular hyperplasia, 761.3198 • Liver neoplasms, CT, 761.12111, 761.12112, 761.12114 • Liver neoplasms, MR, 761.121411, 761.121412, 761.121415, 761.12143 • Liver neoplasms, US, 761.1298




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