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Regenerative and Dysplastic Nodules
Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Dysplastic nodule (DN)
            • Regenerative nodule (RN)
          • Synonyms

            • Cirrhotic nodule
          • Definitions

            • Localized proliferation of liver parenchyma within cirrhotic liver in response to liver injury
              • May progress to become dysplastic or even malignant

          IMAGING

          • General Features

            • Imaging Recommendations

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      • Reporting Tips

                                        Selected References

                                        1. Rich N et al: Hepatocellular carcinoma tumour markers: current role and expectations. Best Pract Res Clin Gastroenterol. 28(5):843-53, 2014
                                        2. Ronot M et al: Hepatocellular carcinoma: diagnostic criteria by imaging techniques. Best Pract Res Clin Gastroenterol. 28(5):795-812, 2014
                                        3. Bartolozzi C et al: Contrast-enhanced magnetic resonance imaging of 102 nodules in cirrhosis: correlation with histological findings on explanted livers. Abdom Imaging. 38(2):290-6, 2013
                                        4. Nakamura S et al: The diagnosis of hypovascular hepatic lesions showing hypo-intensity in the hepatobiliary phase of Gd-EOB- DTPA-enhanced MR imaging in high-risk patients for hepatocellular carcinoma. Acta Med Okayama. 67(4):239-44, 2013
                                        5. Quaia E et al: Predictors of dysplastic nodule diagnosis in patients with liver cirrhosis on unenhanced and gadobenate dimeglumine-enhanced MRI with dynamic and hepatobiliary phase. AJR Am J Roentgenol. 200(3):553-62, 2013
                                        6. Giorgio A et al: Characterization of dysplastic nodules, early hepatocellular carcinoma and progressed hepatocellular carcinoma in cirrhosis with contrast-enhanced ultrasound. Anticancer Res. 31(11):3977-82, 2011
                                        7. Kudo M: Diagnostic imaging of hepatocellular carcinoma: recent progress. Oncology. 81 Suppl 1:73-85, 2011
                                        8. Lee JM et al: Hepatocellular nodules in liver cirrhosis: MR evaluation. Abdom Imaging. 36(3):282-9, 2011
                                        9. Ouedraogo NA et al: Dysplastic hepatic nodules: radiological abnormalities and histopathological correlations. Eur J Radiol. 79(2):232-6, 2011
                                        10. Chou CT et al: Characterization of cirrhotic nodules with gadoxetic acid-enhanced magnetic resonance imaging: the efficacy of hepatocyte-phase imaging. J Magn Reson Imaging. 32(4):895-902, 2010
                                        11. Hanna RF et al: Cirrhosis-associated hepatocellular nodules: correlation of histopathologic and MR imaging features. Radiographics. 28(3):747-69, 2008
                                        12. Lencioni R et al: Guidelines for imaging focal lesions in liver cirrhosis. Expert Rev Gastroenterol Hepatol. 2(5):697-703, 2008
                                        13. Lupescu IG et al: Tissue specific MR contrast media role in the differential diagnosis of cirrhotic liver nodules. J Gastrointestin Liver Dis. 17(3):341-6, 2008
                                        14. Robinson P: Hepatocellular carcinoma: development and early detection. Cancer Imaging. 8 Suppl A:S128-31, 2008
                                        15. Roncalli M et al: Hepatocellular dysplastic nodules. Ann Ital Chir. 79(2):81-9, 2008
                                        16. Krinsky GA et al: Nondysplastic nodules that are hyperintense on T1-weighted gradient-echo MR imaging: frequency in cirrhotic patients undergoing transplantation. AJR Am J Roentgenol. 180(4):1023-7, 2003
                                        17. Hussain SM et al: Benign versus malignant hepatic nodules: MR imaging findings with pathologic correlation. Radiographics. 22(5):1023-36; discussion 1037-9, 2002
                                        18. Krinsky GA et al: Siderotic nodules in the cirrhotic liver at MR imaging with explant correlation: no increased frequency of dysplastic nodules and hepatocellular carcinoma. Radiology. 218(1):47-53, 2001
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Dysplastic nodule (DN)
                                                  • Regenerative nodule (RN)
                                                • Synonyms

                                                  • Cirrhotic nodule
                                                • Definitions

                                                  • Localized proliferation of liver parenchyma within cirrhotic liver in response to liver injury
                                                    • May progress to become dysplastic or even malignant

                                                IMAGING

                                                • General Features

                                                  • Imaging Recommendations

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Image Interpretation Pearls

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Rich N et al: Hepatocellular carcinoma tumour markers: current role and expectations. Best Pract Res Clin Gastroenterol. 28(5):843-53, 2014
                                                                              2. Ronot M et al: Hepatocellular carcinoma: diagnostic criteria by imaging techniques. Best Pract Res Clin Gastroenterol. 28(5):795-812, 2014
                                                                              3. Bartolozzi C et al: Contrast-enhanced magnetic resonance imaging of 102 nodules in cirrhosis: correlation with histological findings on explanted livers. Abdom Imaging. 38(2):290-6, 2013
                                                                              4. Nakamura S et al: The diagnosis of hypovascular hepatic lesions showing hypo-intensity in the hepatobiliary phase of Gd-EOB- DTPA-enhanced MR imaging in high-risk patients for hepatocellular carcinoma. Acta Med Okayama. 67(4):239-44, 2013
                                                                              5. Quaia E et al: Predictors of dysplastic nodule diagnosis in patients with liver cirrhosis on unenhanced and gadobenate dimeglumine-enhanced MRI with dynamic and hepatobiliary phase. AJR Am J Roentgenol. 200(3):553-62, 2013
                                                                              6. Giorgio A et al: Characterization of dysplastic nodules, early hepatocellular carcinoma and progressed hepatocellular carcinoma in cirrhosis with contrast-enhanced ultrasound. Anticancer Res. 31(11):3977-82, 2011
                                                                              7. Kudo M: Diagnostic imaging of hepatocellular carcinoma: recent progress. Oncology. 81 Suppl 1:73-85, 2011
                                                                              8. Lee JM et al: Hepatocellular nodules in liver cirrhosis: MR evaluation. Abdom Imaging. 36(3):282-9, 2011
                                                                              9. Ouedraogo NA et al: Dysplastic hepatic nodules: radiological abnormalities and histopathological correlations. Eur J Radiol. 79(2):232-6, 2011
                                                                              10. Chou CT et al: Characterization of cirrhotic nodules with gadoxetic acid-enhanced magnetic resonance imaging: the efficacy of hepatocyte-phase imaging. J Magn Reson Imaging. 32(4):895-902, 2010
                                                                              11. Hanna RF et al: Cirrhosis-associated hepatocellular nodules: correlation of histopathologic and MR imaging features. Radiographics. 28(3):747-69, 2008
                                                                              12. Lencioni R et al: Guidelines for imaging focal lesions in liver cirrhosis. Expert Rev Gastroenterol Hepatol. 2(5):697-703, 2008
                                                                              13. Lupescu IG et al: Tissue specific MR contrast media role in the differential diagnosis of cirrhotic liver nodules. J Gastrointestin Liver Dis. 17(3):341-6, 2008
                                                                              14. Robinson P: Hepatocellular carcinoma: development and early detection. Cancer Imaging. 8 Suppl A:S128-31, 2008
                                                                              15. Roncalli M et al: Hepatocellular dysplastic nodules. Ann Ital Chir. 79(2):81-9, 2008
                                                                              16. Krinsky GA et al: Nondysplastic nodules that are hyperintense on T1-weighted gradient-echo MR imaging: frequency in cirrhotic patients undergoing transplantation. AJR Am J Roentgenol. 180(4):1023-7, 2003
                                                                              17. Hussain SM et al: Benign versus malignant hepatic nodules: MR imaging findings with pathologic correlation. Radiographics. 22(5):1023-36; discussion 1037-9, 2002
                                                                              18. Krinsky GA et al: Siderotic nodules in the cirrhotic liver at MR imaging with explant correlation: no increased frequency of dysplastic nodules and hepatocellular carcinoma. Radiology. 218(1):47-53, 2001