Regenerating nodules of liver cirrhosis: MR imaging with pathologic correlation

To determine the pathologic basis for low-intensity nodules seen on MR images of the liver in patients with cirrhosis, we obtained spin-echo and gradient-echo MR images in 20 cirrhotic patients in whom partial hepatectomies were subsequently performed for hepatocellular carcinoma. Low-intensity liver nodules were shown on gradient-echo and spin-echo images in eight patients. Pathologic study of the liver in these patients showed that these nodules were regenerating nodules containing hemosiderin. Low-intensity nodules were seen only on T2-weighted spin-echo images in four other patients. Microscopic examination of the liver in these patients showed regenerating nodules without hemosiderin deposits. Broad fibrous septa containing vascular spaces were present in two of these four patients. These results suggest that regenerating nodules containing hemosiderin or those that are surrounded by vascular fibrous septa are visible on MR images as low-intensity nodules and that gradient-echo images are useful in demonstrating nodules with hemosiderin.