link
Bookmarks
Nodular Regenerative Hyperplasia
Michael P. Federle, MD, FACR
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe
0
13
2
8

KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Abbreviations

          • Nodular regenerative hyperplasia (NRH)
        • Synonyms

          • Nodular transformation, noncirrhotic nodulation
        • Definitions

          • Uncommonly recognized disorder characterized by diffuse micronodular or macronodular transformation of hepatic parenchyma without fibrous septa between nodules
          • Larger focal lesions are called multiacinar (large) regenerative nodules (LRNs)

        IMAGING

        • General Features

          • CT Findings

            • MR Findings

              • Ultrasonographic 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. Choe H et al: Nodular regenerative hyperplasia causing portal hypertension in a patient with chronic graft versus host disease: response to sirolimus. Acta Haematol. 132(1):49-52, 2014
                                          2. Morris-Stiff G et al: Nodular regenerative hyperplasia (NRH) complicating oxaliplatin chemotherapy in patients undergoing resection of colorectal liver metastases. Eur J Surg Oncol. 40(8):1016-20, 2014
                                          3. Caturelli E et al: Nodular regenerative hyperplasia of the liver: coral atoll-like lesions on ultrasound are characteristic in predisposed patients. Br J Radiol. 84(1003):e129-34, 2011
                                          4. Gouya H et al: Chronic liver disease: systemic and splanchnic venous flow mapping with optimized cine phase-contrast MR imaging validated in a phantom model and prospectively evaluated in patients. Radiology. 261(1):144-55, 2011
                                          5. Hartleb M et al: Nodular regenerative hyperplasia: evolving concepts on underdiagnosed cause of portal hypertension. World J Gastroenterol. 17(11):1400-9, 2011
                                          6. Maganty K et al: Liver transplantation for hepatopulmonary syndrome due to noncirrhotic portal hypertension. Transplant Proc. 43(7):2814-6, 2011
                                          7. Morana G et al: Solid hypervascular liver lesions: accurate identification of true benign lesions on enhanced dynamic and hepatobiliary phase magnetic resonance imaging after gadobenate dimeglumine administration. Invest Radiol. 46(4):225-39, 2011
                                          8. Schouten JN et al: Idiopathic noncirrhotic portal hypertension. Hepatology. 54(3):1071-81, 2011
                                          9. Ueda T et al: A pictorial review of benign hepatocellular nodular lesions: comprehensive radiological assessment incorporating the concept of anomalous portal tract syndrome. J Hepatobiliary Pancreat Sci. 18(3):386-96, 2011
                                          10. Willatt JM et al: MR Imaging of hepatocellular carcinoma in the cirrhotic liver: challenges and controversies. Radiology. 247(2):311-30, 2008
                                          11. Qayyum A et al: CT of benign hypervascular liver nodules in autoimmune hepatitis. AJR Am J Roentgenol. 183(6):1573-6, 2004
                                          12. Zeitoun D et al: Congenital hepatic fibrosis: CT findings in 18 adults. Radiology. 231(1):109-16, 2004
                                          13. Brancatelli G et al: Benign regenerative nodules in Budd-Chiari syndrome and other vascular disorders of the liver: radiologic-pathologic and clinical correlation. Radiographics. 22(4):847-62, 2002
                                          14. Brancatelli G et al: Large regenerative nodules in Budd-Chiari syndrome and other vascular disorders of the liver: CT and MR imaging findings with clinicopathologic correlation. AJR Am J Roentgenol. 178(4):877-83, 2002
                                          15. MacSween RNH et al: Pathology of the Liver. 4th ed. London: Churchill Livingston. 755-56, 2002
                                          16. Maetani Y et al: Benign hepatic nodules in Budd-Chiari syndrome: radiologic-pathologic correlation with emphasis on the central scar. AJR Am J Roentgenol. 178(4):869-75, 2002
                                          17. Grazioli L et al: Congenital absence of portal vein with nodular regenerative hyperplasia of the liver. Eur Radiol. 10(5):820-5, 2000
                                          18. Rha SE et al: Nodular regenerative hyperplasia of the liver in Budd-Chiari syndrome: CT and MR features. Abdom Imaging. 25(3):255-8, 2000
                                          19. Soler R et al: Benign regenerative nodules with copper accumulation in a case of chronic Budd-Chiari syndrome: CT and MR findings. Abdom Imaging. 25(5):486-9, 2000
                                          20. Zhou H et al: Multiple macroregenerative nodules in liver cirrhosis due to Budd-Chiari syndrome. Case reports and review of the literature. Hepatogastroenterology. 47(32):522-7, 2000
                                          21. Clouet M et al: Imaging features of nodular regenerative hyperplasia of the liver mimicking hepatic metastases. Abdom Imaging. 24(3):258-61, 1999
                                          22. Vilgrain V et al: Hepatic nodules in Budd-Chiari syndrome: imaging features. Radiology. 210(2):443-50, 1999
                                          23. Casillas C et al: Pseudotumoral presentation of nodular regenerative hyperplasia of the liver: imaging in five patients including MR imaging. Eur Radiol. 7(5):654-8, 1997
                                          24. Wanless IR: Micronodular transformation (nodular regenerative hyperplasia) of the liver: a report of 64 cases among 2,500 autopsies and a new classification of benign hepatocellular nodules. Hepatology. 11(5):787-97, 1990
                                          Related Anatomy
                                          Loading...
                                          Related Differential Diagnoses
                                          Loading...
                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Nodular regenerative hyperplasia (NRH)
                                                • Synonyms

                                                  • Nodular transformation, noncirrhotic nodulation
                                                • Definitions

                                                  • Uncommonly recognized disorder characterized by diffuse micronodular or macronodular transformation of hepatic parenchyma without fibrous septa between nodules
                                                  • Larger focal lesions are called multiacinar (large) regenerative nodules (LRNs)

                                                IMAGING

                                                • General Features

                                                  • CT Findings

                                                    • MR Findings

                                                      • Ultrasonographic 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. Choe H et al: Nodular regenerative hyperplasia causing portal hypertension in a patient with chronic graft versus host disease: response to sirolimus. Acta Haematol. 132(1):49-52, 2014
                                                                                  2. Morris-Stiff G et al: Nodular regenerative hyperplasia (NRH) complicating oxaliplatin chemotherapy in patients undergoing resection of colorectal liver metastases. Eur J Surg Oncol. 40(8):1016-20, 2014
                                                                                  3. Caturelli E et al: Nodular regenerative hyperplasia of the liver: coral atoll-like lesions on ultrasound are characteristic in predisposed patients. Br J Radiol. 84(1003):e129-34, 2011
                                                                                  4. Gouya H et al: Chronic liver disease: systemic and splanchnic venous flow mapping with optimized cine phase-contrast MR imaging validated in a phantom model and prospectively evaluated in patients. Radiology. 261(1):144-55, 2011
                                                                                  5. Hartleb M et al: Nodular regenerative hyperplasia: evolving concepts on underdiagnosed cause of portal hypertension. World J Gastroenterol. 17(11):1400-9, 2011
                                                                                  6. Maganty K et al: Liver transplantation for hepatopulmonary syndrome due to noncirrhotic portal hypertension. Transplant Proc. 43(7):2814-6, 2011
                                                                                  7. Morana G et al: Solid hypervascular liver lesions: accurate identification of true benign lesions on enhanced dynamic and hepatobiliary phase magnetic resonance imaging after gadobenate dimeglumine administration. Invest Radiol. 46(4):225-39, 2011
                                                                                  8. Schouten JN et al: Idiopathic noncirrhotic portal hypertension. Hepatology. 54(3):1071-81, 2011
                                                                                  9. Ueda T et al: A pictorial review of benign hepatocellular nodular lesions: comprehensive radiological assessment incorporating the concept of anomalous portal tract syndrome. J Hepatobiliary Pancreat Sci. 18(3):386-96, 2011
                                                                                  10. Willatt JM et al: MR Imaging of hepatocellular carcinoma in the cirrhotic liver: challenges and controversies. Radiology. 247(2):311-30, 2008
                                                                                  11. Qayyum A et al: CT of benign hypervascular liver nodules in autoimmune hepatitis. AJR Am J Roentgenol. 183(6):1573-6, 2004
                                                                                  12. Zeitoun D et al: Congenital hepatic fibrosis: CT findings in 18 adults. Radiology. 231(1):109-16, 2004
                                                                                  13. Brancatelli G et al: Benign regenerative nodules in Budd-Chiari syndrome and other vascular disorders of the liver: radiologic-pathologic and clinical correlation. Radiographics. 22(4):847-62, 2002
                                                                                  14. Brancatelli G et al: Large regenerative nodules in Budd-Chiari syndrome and other vascular disorders of the liver: CT and MR imaging findings with clinicopathologic correlation. AJR Am J Roentgenol. 178(4):877-83, 2002
                                                                                  15. MacSween RNH et al: Pathology of the Liver. 4th ed. London: Churchill Livingston. 755-56, 2002
                                                                                  16. Maetani Y et al: Benign hepatic nodules in Budd-Chiari syndrome: radiologic-pathologic correlation with emphasis on the central scar. AJR Am J Roentgenol. 178(4):869-75, 2002
                                                                                  17. Grazioli L et al: Congenital absence of portal vein with nodular regenerative hyperplasia of the liver. Eur Radiol. 10(5):820-5, 2000
                                                                                  18. Rha SE et al: Nodular regenerative hyperplasia of the liver in Budd-Chiari syndrome: CT and MR features. Abdom Imaging. 25(3):255-8, 2000
                                                                                  19. Soler R et al: Benign regenerative nodules with copper accumulation in a case of chronic Budd-Chiari syndrome: CT and MR findings. Abdom Imaging. 25(5):486-9, 2000
                                                                                  20. Zhou H et al: Multiple macroregenerative nodules in liver cirrhosis due to Budd-Chiari syndrome. Case reports and review of the literature. Hepatogastroenterology. 47(32):522-7, 2000
                                                                                  21. Clouet M et al: Imaging features of nodular regenerative hyperplasia of the liver mimicking hepatic metastases. Abdom Imaging. 24(3):258-61, 1999
                                                                                  22. Vilgrain V et al: Hepatic nodules in Budd-Chiari syndrome: imaging features. Radiology. 210(2):443-50, 1999
                                                                                  23. Casillas C et al: Pseudotumoral presentation of nodular regenerative hyperplasia of the liver: imaging in five patients including MR imaging. Eur Radiol. 7(5):654-8, 1997
                                                                                  24. Wanless IR: Micronodular transformation (nodular regenerative hyperplasia) of the liver: a report of 64 cases among 2,500 autopsies and a new classification of benign hepatocellular nodules. Hepatology. 11(5):787-97, 1990