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Detection of the draining vein from hepatic focal nodular hyperplasia on three-dimensional computed tomography
Shoji Kubo1, Akishige Kanazawa, Masato Yamasaki
1Department of Gastroenterological and Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. m7696493@msic.med.osaka-cu.ac.jp
Insights
Diagnosing liver tumors like focal nodular hyperplasia (FNH) can be challenging. Three-dimensional computed tomography (3D-CT) aided in identifying FNH by visualizing its unique vascular patterns, including a draining vein.
Area of Science:
- Hepatology
- Radiology
- Medical Imaging
Background:
- Differentiating focal nodular hyperplasia (FNH) from other hepatic tumors is clinically significant.
- Accurate diagnosis is crucial for appropriate patient management and treatment planning.
Observation:
- A case study involving a 31-year-old female presenting with epigastric pain and a liver tumor.
- Initial imaging (ultrasonography, CT) revealed a liver tumor.
- Three-dimensional computed tomography (3D-CT) demonstrated a hypervascular lesion with specific enhancement characteristics.
Findings:
- 3D-CT revealed a hypervascular liver lesion with a hypodense center and prominent feeding arteries on early imaging.
- A characteristic draining vein connecting to the hepatic vein was visualized on delayed CT images.
- Pathological examination confirmed the lesion as focal nodular hyperplasia, despite initial concerns due to tumor growth.
Implications:
- The presence of a draining vein connecting to the hepatic vein may be a distinctive imaging feature of FNH.
- Three-dimensional computed tomography offers valuable insights for diagnosing focal nodular hyperplasia of the liver.
- Advanced imaging techniques like 3D-CT can improve diagnostic accuracy for challenging liver lesions.
Abstract:
It is sometimes difficult to differentiate focal nodular hyperplasia from other hepatic tumors. A report is presented of a patient in whom three-dimensional computed tomography was useful to diagnose focal nodular hyperplasia of the liver. In a 31-year-old women with epigastralgia, ultrasonography and computed tomograms showed a tumor in the liver. Three-dimensional computed tomograms showed a hypervascular lesion with a hypodense interior and feeding arteries on early images. On delayed images, a draining vein connecting with the hepatic vein was clearly demonstrated. Although focal nodular hyperplasia was strongly suspected, the tumor was resected because of the enlargement and extrahepatic growth of the tumor. Pathologic examination showed that the tumor was focal nodular hyperplasia of the liver. A draining vein connecting to the hepatic vein may be a characteristic of focal nodular hyperplasia. Three-dimensional computed tomography may be useful to diagnose focal nodular hyperplasia of the liver.
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