Download Abdominal and Pelvic MRI by Guy Marchal MD (auth.), Andreas Heuck MD, Maximilian Reiser PDF

By Guy Marchal MD (auth.), Andreas Heuck MD, Maximilian Reiser MD (eds.)

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1993; RUMMENY et al. 1991b; MURAKAMI et al. 1996). Recently several groups have shown that superparamagnetic iron oxide (SPIO)-enhanced MRI can be helpful in the diagnosis of FNH. Because of RES cells within the tumor, FNH shows uptake of SPIO that parallels uptake of technetium-99m sulfur colloid in nuclear medicine (GRANDIN et al. 1995). Therefore the tumor signal intensity on SPIOenhanced T2-weighted images is significantly lower than on nonenhanced images (VOGL et al. 1996; GRANDIN et al. 1995).

Hepatic cysts are reported to be present in between 5% and 14% of the population, with a higher prevalence in women (CRAIG et al. 1989). Cysts usually occur without any clinical symptoms and are seen as incidental masses at hepatic imaging or surgery. Rarely they can be symptomatic due to infection or bleeding, or produce pain due to a mass effect which may necessitate surgical therapy. Radiologic differentiation of simple hepatic cysts from other primary or secondary liver tumors is not difficult.

Its etiology is unknown, but there may be a hormonal influence because FNH is more common in women in their 3rd to 5th decades. Pathologically FNH is a well-circumscribed, usually solitary mass characterized by central scar tissue with surrounding nodules of hyperplastic hepatocytes which are divided into lobules by thin septa that radiate from the central scar (CRAIG et al. 1989; CASARELLA et al. 1978; KNOWLES and WOLFF 1976; KERLIN et al. 1983). No normal portal venous structures are present, although bile ducts and arterial vessels course through the tumor and are prominent in the fibrous scar and along the septa that extend from the center to the periphery.

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