Right hepatic lobe lesion on ultrasound ABDOMEN:LIVER, BILIARY TRACT: Moderately T2 hyperintense segment 8 lesion demonstrates arterial enhancement and mild progressive enhancement measuring 1.8 x 1.4 cm (series 4, image 11), suggestive of an FNH. No adjacent biliary duct dilatation or capsular retraction seen. Intralesional signal dropout seen on opposed-phase imaging, consistent with intravoxel fat, may be seen with an HNF alpha1 mutated type of adenoma or an FNH. The former would typically have become isointense in the portal venous and delayed phases of postcontrast imaging, unlike in this case, where contrast retention was evident. T2 hyperintense lesion in segment 7 adjacent to the intrahepatic IVC measures 1.6 x 1.0 cm with peripheral nodular enhancement, appearance consistent with a hemangioma. Additional scattered subcentimeter T2 hyperintense foci are noted throughout the liver with characteristics consistent with cysts and flash filling hemangiomas.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix is normal.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Arterially enhancing segment 8 hepatic lesion with signal characteristics most consistent with FNH (focal nodular hyperplasia); adenoma is considered less likely. If followup imaging is pursued, 1-hour delay imaging following the administration of IV contrast would be helpful in improved differentiation and confirmation of an FNH. 2. Segment 7 hepatic lesion with signal characteristics consistent with a hemangioma.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.