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
Vernuccio F et al: Spectrum of liver lesions hyperintense on hepatobiliary phase: an approach by clinical setting. Insights Imaging. 12(1):8, 2021
Bakshi N et al: Nodular regenerative hyperplasia - an under-recognized vascular disorder of liver. Pathol Res Pract. 216(4):152833, 2020
Penrice D et al: Nodular regenerative hyperplasia associated with primary liver malignancies. Hepatology. 71(2):760-1, 2020
Navin PJ et al: The utility of MR elastography to differentiate nodular regenerative hyperplasia from cirrhosis. Hepatology. 69(1):452-4, 2019
Piao C et al: Noncirrhotic portal hypertension secondary to nodular regenerative hyperplasia postrenal transplant. ACG Case Rep J. 6(12):e00257, 2019
Lepelley M et al: Nodular regenerative hyperplasia induced by trastuzumab emtansine: role of emtansine? Ann Hepatol. 17(6):1067-71, 2018
Xiang H et al: Liver atoll sign: nodular regenerative hyperplasia. J Med Imaging Radiat Oncol. 62 Suppl 1:88, 2018
Yoneda N et al: Benign hepatocellular nodules: hepatobiliary phase of gadoxetic acid-enhanced MR imaging based on molecular background. Radiographics. 36(7):2010-27, 2016
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
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
Nodular regenerative hyperplasia. In: LiverTox: clinical and research information on drug-induced liver injury [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases, 2012
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
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
Hartleb M et al: Nodular regenerative hyperplasia: evolving concepts on underdiagnosed cause of portal hypertension. World J Gastroenterol. 17(11):1400-9, 2011
Maganty K et al: Liver transplantation for hepatopulmonary syndrome due to noncirrhotic portal hypertension. Transplant Proc. 43(7):2814-6, 2011
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
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
Walldorf J et al: Rapid development of a hepatocellular carcinoma in isolated thrombosis of hepatic veins (classic Budd-Chiari syndrome): case report and review of literature. BMJ Case Rep. 2009, 2009
Willatt JM et al: MR Imaging of hepatocellular carcinoma in the cirrhotic liver: challenges and controversies. Radiology. 247(2):311-30, 2008
Qayyum A et al: CT of benign hypervascular liver nodules in autoimmune hepatitis. AJR Am J Roentgenol. 183(6):1573-6, 2004
Zeitoun D et al: Congenital hepatic fibrosis: CT findings in 18 adults. Radiology. 231(1):109-16, 2004
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
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
MacSween RNH et al: Pathology of the Liver. 4th ed. London: Churchill Livingston. 755-56, 2002
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
Grazioli L et al: Congenital absence of portal vein with nodular regenerative hyperplasia of the liver. Eur Radiol. 10(5):820-5, 2000
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
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
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
Clouet M et al: Imaging features of nodular regenerative hyperplasia of the liver mimicking hepatic metastases. Abdom Imaging. 24(3):258-61, 1999
Vilgrain V et al: Hepatic nodules in Budd-Chiari syndrome: imaging features. Radiology. 210(2):443-50, 1999
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
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
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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
Vernuccio F et al: Spectrum of liver lesions hyperintense on hepatobiliary phase: an approach by clinical setting. Insights Imaging. 12(1):8, 2021
Bakshi N et al: Nodular regenerative hyperplasia - an under-recognized vascular disorder of liver. Pathol Res Pract. 216(4):152833, 2020
Penrice D et al: Nodular regenerative hyperplasia associated with primary liver malignancies. Hepatology. 71(2):760-1, 2020
Navin PJ et al: The utility of MR elastography to differentiate nodular regenerative hyperplasia from cirrhosis. Hepatology. 69(1):452-4, 2019
Piao C et al: Noncirrhotic portal hypertension secondary to nodular regenerative hyperplasia postrenal transplant. ACG Case Rep J. 6(12):e00257, 2019
Lepelley M et al: Nodular regenerative hyperplasia induced by trastuzumab emtansine: role of emtansine? Ann Hepatol. 17(6):1067-71, 2018
Xiang H et al: Liver atoll sign: nodular regenerative hyperplasia. J Med Imaging Radiat Oncol. 62 Suppl 1:88, 2018
Yoneda N et al: Benign hepatocellular nodules: hepatobiliary phase of gadoxetic acid-enhanced MR imaging based on molecular background. Radiographics. 36(7):2010-27, 2016
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
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
Nodular regenerative hyperplasia. In: LiverTox: clinical and research information on drug-induced liver injury [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases, 2012
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
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
Hartleb M et al: Nodular regenerative hyperplasia: evolving concepts on underdiagnosed cause of portal hypertension. World J Gastroenterol. 17(11):1400-9, 2011
Maganty K et al: Liver transplantation for hepatopulmonary syndrome due to noncirrhotic portal hypertension. Transplant Proc. 43(7):2814-6, 2011
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
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
Walldorf J et al: Rapid development of a hepatocellular carcinoma in isolated thrombosis of hepatic veins (classic Budd-Chiari syndrome): case report and review of literature. BMJ Case Rep. 2009, 2009
Willatt JM et al: MR Imaging of hepatocellular carcinoma in the cirrhotic liver: challenges and controversies. Radiology. 247(2):311-30, 2008
Qayyum A et al: CT of benign hypervascular liver nodules in autoimmune hepatitis. AJR Am J Roentgenol. 183(6):1573-6, 2004
Zeitoun D et al: Congenital hepatic fibrosis: CT findings in 18 adults. Radiology. 231(1):109-16, 2004
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
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
MacSween RNH et al: Pathology of the Liver. 4th ed. London: Churchill Livingston. 755-56, 2002
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
Grazioli L et al: Congenital absence of portal vein with nodular regenerative hyperplasia of the liver. Eur Radiol. 10(5):820-5, 2000
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
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
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
Clouet M et al: Imaging features of nodular regenerative hyperplasia of the liver mimicking hepatic metastases. Abdom Imaging. 24(3):258-61, 1999
Vilgrain V et al: Hepatic nodules in Budd-Chiari syndrome: imaging features. Radiology. 210(2):443-50, 1999
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
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
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