ArticleMagnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine2026
Potential to Avoid Invasive Procedures for Atypical Focal Nodular Hyperplasia (FNH) and FNH-like Lesions Based on MR Findings.
Article in Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo identify the imaging characteristics of rare, histopathologically confirmed focal nodular hyperplasia (FNH) and FNH-like lesions (FNH/FNH-like lesions) and determine whether invasive procedures could have been avoided by comprehensive MRI review.
methodsWe retrospectively enrolled patients with pathologically confirmed FNH/FNH-like lesions between January 2011 and December 2023. These cases underwent biopsy or resection due to their atypical hepatobiliary phase appearance. Six patients with hepatocellular carcinoma (HCC) were included from a separate cohort for comparison. Gadoxetic acid-enhanced MRI findings were qualitatively evaluated. Apparent diffusion coefficient (ADC) values and enhancement during the hepatobiliary phase were quantitatively assessed, and the relative enhancement ratio (RER) to liver parenchyma and intrahepatic vessel (RERv) was calculated. Organic anion transporting polypeptides (OATP)1B3 expression was confirmed histopathologically.
resultsFive patients with FNH/FNH-like lesions and 6 patients with HCC were evaluated. The non-contrast MRI findings were non-specific for both groups. All 5 FNH/FNH-like lesions displayed non-rim arterial phase hyperenhancement (APHE) without washout during dynamic contrast study with ADC values of 1.162 ± 0.124 × 10
conclusionFNH/FNH-like lesions with hepatobiliary phase hypointensity, the characteristic finding of hyperintensity relative to intrahepatic vessels distinguished them from similarly presenting HCCs. Careful evaluation of this specific imaging feature might have potentially avoided the need for invasive treatment or biopsy in these diagnostically challenging cases.
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