Focal nodular hyperplasia in liver
Prof. Valette, Pierre-Jean, M.D.
Lyon South Hospital, Hospices Civils de Lyon
In a 45-year-old woman recently operated for a breast cancer, ultrasound revealed a right hepatic nodular lesion.
The exam was done Ingenia 3.0T with dS Torso coil solution, patient feet first, arms up.
Ingenia’s dS Torso coil solution has a large coverage. With this coil setup, whole abdomen acquisition is a single step for most patients. So, it is much faster to perform, for instance, bowel MRI for inflammatory diseases or tumors.
T1 mDIXON arterial phase
T1W mDIXON portal phase
VRT liver vessels
T1-weighted images at arterial and late phase demonstrate a small mass, markedly hypervascular at the arterial phase, isointense to the liver at the late phase except persistent enhancement of fibrous septa, making a characteristic aspect of FNH. On the T2-weighted image the nodule is moderately hyperintense. The 3D image demonstrates the spatial arrangement of the hepatic artery, the portal vein and hepatic veins showing the anatomical relationship of the hepatic nodule with the vascular liver structures.
Typical hepatic focal nodular hyperplasia.
Ingenia’s wide 70 cm bore enables to improve imaging strategy by implementing the high dS SENSE speedup in RL direction with arms-up patient positioning. This allows using a narrowed acquisition volume without the patient’s arms causing artifacts. This provides shorter breath hold times, higher resolution and sharper images because of reduced blurring in TSE and less distortion in DWI.
This positioning is accepted by almost every patient, but requires an examination time not exceeding 20 to 25 minutes. The use of high RL dS SENSE factors in combination with arms-up provides a real advantage. So often with MR, when you change something, you lose something somewhere else. In this case, it is just advantages.