Typical FNH - Focus on the arterial phase appearance
Pathology: A typical FNH has following features:
1. Well demarcated with nodular appearance
2. It is unencapsulated
3. Has a central scar with multiple fibrous septations, which divides the mass into multiple nodules.
4. It has a prominent central artery and drainage is into hepatic veins. (spoke of wheels sign on contrast ultrasound)
5. Does not have portal supply (don't expect its visibility in other phases)
Protocol:
T2W FS / T1 W Dixon / DWI (b=800)-ADC/ Multi-phase dynamic with gadolinium
Appearance:
1. Baseline Imaging: Camouflaging (not so well seen)
2. Restriction of diffusion: usually lower than liver, but variable
3. Arterial phase: Avidly enhancing with lobulated margins. Non-enhancing central scar and fibrous septa
4. Delayed: Enhancement of the scar
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