Regenerating nodules of liver cirrhosis: MR imaging

A large number of tiny (0.5-1.5 cm), low-intensity nodules of the liver were retrospectively observed on T2-weighted magnetic resonance (MR) images of eight patients with cirrhosis of the liver. The lesions were not detected with other imaging modalities and were considered to be regenerating nodules. Twenty-five consecutive cases of liver cirrhosis referred for MR examination were prospectively investigated to study the detectability of regenerating nodules and the optimal pulse sequence for detection. A large number of small, low-intensity nodules were demonstrated in nine of 25 cases on T2-weighted spin-echo (SE) images, in nine of 22 cases on T1-T2 complex fast low-angle shot (FLASH) images, and in one of eight cases on T1-weighted SE images. FLASH images obtained with respiratory suspension most clearly revealed regenerating nodules. However, T2-weighted SE images clearly permit differentiation of high-intensity hepatocellular carcinoma, including small daughter lesions, from low-intensity regenerating nodules.