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Focal Nodular Hyperplasia: Morphologic and Functional Information from MR Imaging with Gadobenate Dimeglumine¹

¹ From the Department of Radiology, University of Brescia, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25023 Brescia, Italy (L.G., K.M., L.O.); Departments of Radiology (G.M., M.T., C.P.) and Surgery (N.N.), University of Verona, Italy; Department of Radiology, University of Pittsburgh Medical Center, Pa (M.P.F., G.B.); and Bracco, Milan, Italy (M.A.K.). Received December 11, 2000; revision requested February 3, 2001; revision received April 23; accepted May 25. Address correspondence to L.G. (e-mail: lgrazioli@yahoo.com).

PURPOSE: To determine whether gadobenate dimeglumine (Gd-BOPTA) is able to provide morphologic and functional information for characterization of focal nodular hyperplasia (FNH).

MATERIALS AND METHODS: Sixty-three consecutive patients with proved FNH were retrospectively examined. Magnetic resonance (MR) imaging with T2-weighted turbo spin-echo and T1-weighted gradient-echo sequences was performed. Images were acquired prior to and during the dynamic phase of contrast-material enhancement and 1-3 hours after administration of 0.1 mmol/kg Gd-BOPTA. Qualitative analysis of signal intensity and homogeneity on images in the various phases of the MR study and examination for the presence of central scar or atypical features were performed. On the basis of features observed in the precontrast and dynamic phases, lesions were defined as typical or atypical. Intensity and enhancement patterns of the lesions and scars were also evaluated in the delayed phase.

RESULTS: One hundred FNHs were depicted on MR images. Seventy-nine of 100 lesions demonstrated typical morphologic and enhancement characteristics. On delayed phase images, 72% of 100 FNHs appeared hyperintense; 21%, isointense; and 7%, slightly hypointense. The delayed pattern of enhancement was homogeneous, heterogeneous, and peripheral in 58%, 22%, and 20% of 100 FNHs, respectively. Atypical morphologic features and lesion and/or scar enhancement were observed in 21 of 100 FNHs. On delayed phase images, 76% of 100 atypical FNHs appeared hyperintense, 14% isointense, and 10% slightly hypointense. Hyperintensity and isointensity allowed the correct characterization in 90% of atypical FNHs.

CONCLUSION: Gd-BOPTA during both dynamic and delayed phases provides morphologic and functional information for the characterization of FNH.

Index terms: Gadobenate dimeglumine • Iron • Liver, focal nodular hyperplasia, 761.3198 • Liver neoplasm, diagnosis, 761.3198 • Liver neoplasm, MR, 761.121411, 761.121412 • Magnetic resonance (MR), contrast media, 761.12143 • Manganese

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