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Focal Nodular Hyperplasia
Hee Sun Park, MD, PhD; Aya Kamaya, MD, FSRU, FSAR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Focal nodular hyperplasia (FNH)
              • Definitions

                • Benign tumor of liver caused by hyperplastic response to localized vascular abnormality

              IMAGING

              • General Features

                • Ultrasonographic Findings

                  • CT Findings

                    • MR Findings

                      • Angiographic Findings

                        • Nuclear Medicine Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Kong WT et al: Contrast-enhanced ultrasound in combination with color Doppler ultrasound can improve the diagnostic performance of focal nodular hyperplasia and hepatocellular adenoma. Ultrasound Med Biol. 41(4):944-51, 2015
                                                2. Li W et al: Differentiation of atypical hepatocellular carcinoma from focal nodular hyperplasia: diagnostic performance of contrast-enhanced US and microflow imaging. Radiology. 140911, 2015
                                                3. Suh CH et al: The diagnostic value of Gd-EOB-DTPA-MRI for the diagnosis of focal nodular hyperplasia: a systematic review and meta-analysis. Eur Radiol. 25(4):950-60, 2015
                                                4. Bertin C et al: Contrast-enhanced ultrasound of focal nodular hyperplasia: a matter of size. Eur Radiol. 24(10):2561-71, 2014
                                                5. Cristiano A et al: Focal nodular hyperplasia and hepatic adenoma: current diagnosis and management. Updates Surg. Epub ahead of print, 2013
                                                6. Pei XQ et al: Quantitative analysis of contrast-enhanced ultrasonography: differentiating focal nodular hyperplasia from hepatocellular carcinoma. Br J Radiol. 86(1023):20120536, 2013
                                                7. Wang W et al: Contrast-enhanced ultrasound features of histologically proven focal nodular hyperplasia: diagnostic performance compared with contrast-enhanced CT. Eur Radiol. 23(9):2546-54, 2013
                                                8. Bonder A et al: Evaluation of liver lesions. Clin Liver Dis. 16(2):271-83, 2012
                                                9. Wu S et al: The frequency and clinical significance of the halo sign in focal nodular hyperplasia of the liver. Med Ultrason. 14(4):278-82, 2012
                                                10. Quaia E: The real capabilities of contrast-enhanced ultrasound in the characterization of solid focal liver lesions. Eur Radiol. 21(3):457-62, 2011
                                                11. Piscaglia F et al: Characterization of focal liver lesions with contrast-enhanced ultrasound. Ultrasound Med Biol. 36(4):531-50, 2010
                                                12. Piscaglia F et al: Diagnostic features of real-time contrast-enhanced ultrasound in focal nodular hyperplasia of the liver. Ultraschall Med. 31(3):276-82, 2010
                                                13. Seitz K et al: Contrast-enhanced ultrasound (CEUS) for the characterization of focal liver lesions in clinical practice (DEGUM Multicenter Trial): CEUS vs. MRI--a prospective comparison in 269 patients. Ultraschall Med. 31(5):492-9, 2010
                                                14. van den Esschert JW et al: Imaging modalities for focal nodular hyperplasia and hepatocellular adenoma. Dig Surg. 27(1):46-55, 2010
                                                15. Jang HJ et al: Contrast-enhanced ultrasound in the detection and characterization of liver tumors. Cancer Imaging. 9:96-103, 2009
                                                16. Kamaya A et al: Hypervascular liver lesions. Semin Ultrasound CT MR. 30(5):387-407, 2009
                                                17. Trillaud H et al: Characterization of focal liver lesions with SonoVue-enhanced sonography: international multicenter-study in comparison to CT and MRI. World J Gastroenterol. 15(30):3748-56, 2009
                                                18. Xu HX et al: Characterization of small focal liver lesions using real-time contrast-enhanced sonography: diagnostic performance analysis in 200 patients. J Ultrasound Med. 25(3):349-61, 2006
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Focal nodular hyperplasia (FNH)
                                                            • Definitions

                                                              • Benign tumor of liver caused by hyperplastic response to localized vascular abnormality

                                                            IMAGING

                                                            • General Features

                                                              • Ultrasonographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Angiographic Findings

                                                                      • Nuclear Medicine Findings

                                                                        • Imaging Recommendations

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Kong WT et al: Contrast-enhanced ultrasound in combination with color Doppler ultrasound can improve the diagnostic performance of focal nodular hyperplasia and hepatocellular adenoma. Ultrasound Med Biol. 41(4):944-51, 2015
                                                                                              2. Li W et al: Differentiation of atypical hepatocellular carcinoma from focal nodular hyperplasia: diagnostic performance of contrast-enhanced US and microflow imaging. Radiology. 140911, 2015
                                                                                              3. Suh CH et al: The diagnostic value of Gd-EOB-DTPA-MRI for the diagnosis of focal nodular hyperplasia: a systematic review and meta-analysis. Eur Radiol. 25(4):950-60, 2015
                                                                                              4. Bertin C et al: Contrast-enhanced ultrasound of focal nodular hyperplasia: a matter of size. Eur Radiol. 24(10):2561-71, 2014
                                                                                              5. Cristiano A et al: Focal nodular hyperplasia and hepatic adenoma: current diagnosis and management. Updates Surg. Epub ahead of print, 2013
                                                                                              6. Pei XQ et al: Quantitative analysis of contrast-enhanced ultrasonography: differentiating focal nodular hyperplasia from hepatocellular carcinoma. Br J Radiol. 86(1023):20120536, 2013
                                                                                              7. Wang W et al: Contrast-enhanced ultrasound features of histologically proven focal nodular hyperplasia: diagnostic performance compared with contrast-enhanced CT. Eur Radiol. 23(9):2546-54, 2013
                                                                                              8. Bonder A et al: Evaluation of liver lesions. Clin Liver Dis. 16(2):271-83, 2012
                                                                                              9. Wu S et al: The frequency and clinical significance of the halo sign in focal nodular hyperplasia of the liver. Med Ultrason. 14(4):278-82, 2012
                                                                                              10. Quaia E: The real capabilities of contrast-enhanced ultrasound in the characterization of solid focal liver lesions. Eur Radiol. 21(3):457-62, 2011
                                                                                              11. Piscaglia F et al: Characterization of focal liver lesions with contrast-enhanced ultrasound. Ultrasound Med Biol. 36(4):531-50, 2010
                                                                                              12. Piscaglia F et al: Diagnostic features of real-time contrast-enhanced ultrasound in focal nodular hyperplasia of the liver. Ultraschall Med. 31(3):276-82, 2010
                                                                                              13. Seitz K et al: Contrast-enhanced ultrasound (CEUS) for the characterization of focal liver lesions in clinical practice (DEGUM Multicenter Trial): CEUS vs. MRI--a prospective comparison in 269 patients. Ultraschall Med. 31(5):492-9, 2010
                                                                                              14. van den Esschert JW et al: Imaging modalities for focal nodular hyperplasia and hepatocellular adenoma. Dig Surg. 27(1):46-55, 2010
                                                                                              15. Jang HJ et al: Contrast-enhanced ultrasound in the detection and characterization of liver tumors. Cancer Imaging. 9:96-103, 2009
                                                                                              16. Kamaya A et al: Hypervascular liver lesions. Semin Ultrasound CT MR. 30(5):387-407, 2009
                                                                                              17. Trillaud H et al: Characterization of focal liver lesions with SonoVue-enhanced sonography: international multicenter-study in comparison to CT and MRI. World J Gastroenterol. 15(30):3748-56, 2009
                                                                                              18. Xu HX et al: Characterization of small focal liver lesions using real-time contrast-enhanced sonography: diagnostic performance analysis in 200 patients. J Ultrasound Med. 25(3):349-61, 2006