Wk 1, Case 2 - Review

PATIENT HISTORY: Indeterminate liver mass

MRI abdomen with and without intravenous contrast

INDICATION: Liver mass.

COMPARISON: None.

TECHNIQUE: MRI of the abdomen was performed with and without intravenous contrast (Eovist).

FINDINGS

Liver:
- In segment V, there is a 4.9 cm mass which is mildly T2 hyperintense with respect to the liver parenchyma and hypointense on the T1-weighted images. This demonstrates brisk, homogeneous arterial enhancement becoming increasingly isointense to the liver parenchyma on the remaining phases. On the delayed hepatobiliary phase, no masses hyperintense with respect to the liver parenchyma. Overall findings are most compatible with focal nodular hyperplasia.

- In segment VII/VIII, there is a 1.4 cm lesion which demonstrates arterial phase hyperenhancement; this is not well seen on the remaining sequences and therefore it is possible this is perfusional in etiology.

- A right hepatic cyst is also noted.

Hepatic vasculature: Patent.

Gallbladder: Status post cholecystectomy.

Pancreas: Unremarkable.

Spleen: Unremarkable.

Adrenal glands: Unremarkable.

Kidneys: Unremarkable.

Bowel: Visualized bowel is unremarkable.

Lymph nodes: No lymphadenopathy.

Peritoneum: No ascites.

IMPRESSION:

Segment V liver lesion with imaging features most compatible with focal nodular hyperplasia as described.