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Multiple Focal Nodular Hyperplasia

Case Study
Prof. Matos, Celso, M.D. Brussels, Erasme Hospital

Patient history

A 43-year-old female with abdominal pain and abnormal liver function tests presented for an MRI examination at Erasme Hospital.

MR examination

Achieva 3.0T TX was used with the SENSE Torso XL coil.

Exam included the following sequences:
1. Axial single-shot respiratory triggered TSE T2-weighted. Voxel size 1.2x1.6x4 mm3; TE 80 ms; TSE factor 62; P SENSE factor 2.
2. Axial high resolution respiratory triggered low b value (10 s/mm2) DWI. Voxel size 1.83x1.89x5 mm3; TR 1200 ms; TE 60 ms; SENSE factor 3; nominal acquisition time 2.42 min.
3. Axial and coronal THRIVE. Voxel size 1.49x1.5x3 mm3; TR 3 ms; TE 1.42 ms; SENSE factor 2x1.3).

Images

 T2W TSE DWI low b-value
T2W TSE
DWI low b-value
 Delayed e-THRIVE Delayed e-THRIVE
Delayed e-THRIVE
Delayed e-THRIVE

Axial TSE T2-weighted section through the dome of the liver shows a focal lesion slighty hyperintense to adjacent normal liver tissue (arrow). Contrast between the lesion and the adjacent liver is enhanced at low b-value DWI.

Delayed contrast enhanced axial and coronal e-THRIVE sections show three lesions (in coronal) enhanced relative to adjacent liver which is related to the presence of functional normal hepatocytes in the lesion, characteristic of focal nodular hyperplasia.

Diagnosis

The findings are consistent with multiple Focal Nodular Hyperplasia.

Clinical impact of the Achieva 3.0T TX with MultiTransmit

The Achieva 3.0T with MultiTransmit consistently enhances image and contrast uniformity and improves reproducibility which benefits diagnosis and follow-up in oncology patients.

The low b-value DWI better depicts focal liver lesions than the T2-weighted TSE images. High resolution e-THRIVE along with liver specific contrast agents produces superb morphologic and functional information facilitating characterization.

Related reading:



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Case Study
Achieva 3.0T
Release 2, Release 3
Abdomen, Body, DWI, e-THRIVE, FNH, Liver, MultiTransmit, Oncology, SENSE Torso XL coil
 

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