1. 74Hyper enhancing Focal Liver
Lesions

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig GI 74-1 Hepatocellular carcinoma. (A)
Noncontrast scan shows the lesion (H) as an
ill-defined, low-attenuation mass. (B) Scan
during peak arterial contrast shows striking
enhancement throughout the mass.133

4. • Fig GI 74-2 Hemangioma. Arterial phase scan
reveals a small homogeneous, hypervascular
nodule, which remained homogeneously
hyperdense during the portal vein phase (not
shown).134

5. • Fig GI 74-3 Focal nodular hyperplasia. (A) On
the nonenhanced scan, it is very difficult to
detect the lesion in the medial segment of the
left hepatic lobe. (B) On the early contrast
scan, the lesion is uniformly enhanced and
well defined. Note the small central stellate
scar (open arrow).135

6. • Fig GI 74-4 Hepatocellular adenoma. Early
contrast scan shows marked diffuse
enhancement of the lesion (arrows).133

7. • Fig GI 74-5 Metastasis. Enhancing mass
(curved arrow) in the right hepatic lobe that is
especially clear against the background of a
diffuse fatty liver.135

8. • Fig GI 74-6 Hemangioma. (A) Portal vein-phase
scan shows globular hyperenhancing areas in
the periphery of the large lesion
(arrowheads). (B) During the equilibrium
phase, there is progressive peripheral pooling
of contrast material.134

9. • Fig GI 74-7 Hepatocellular carcinoma. Portal
vein-phase study shows the hypervascular
tumor with mosaic pattern (arrow).134

10. • Fig GI 74-8 Focal nodular hyperplasia.
Homogeneous enhancement during the portal
vein phase. The lesion appears hyperdense
because of the background of fatty liver
parenchyma.134

11. • Fig GI 74-9 Solitary fibrous liver tumor. (A)
Portal vein-phase scan shows heterogeneous
areas of enhancement. (B) In the equilibrium
phase, there is striking hyperenhancement of
the lesion.134

12. • Fig GI 74-10 “Hot-spot” lesion. Geographic
hyperenhancing lesion at the dome of the
liver (arrow) in this patient with Hodgkin's
lymphoma and superior vena cava
thrombosis.134