Hepatic focal nodular hyperplasia: angiography, CT, sonography, and scintigraphy

Eleven patients with focal nodular hyperplasia of the liver underwent a combination of radiologic procedures, including sonography, computed tomography (CT), hepatic scintigraphy, and angiography. This paper describes the radiologic findings in this group of patients and reviews the current literature. In the present series, sonography was the most sensitive (100%) method for detection of focal nodular hyperplasia, while CT was able to detect only seven (78%) of nine cases. Arteriographic findings were felt to be characteristic in nine (82%) of 11 cases. Hepatic scintigraphy demonstrated normal colloid uptake in six (55%) of 11 lesions. In this series, an accurate radiologic diagnosis of focal nodular hyperplasia was made in 73% of cases. Hepatic scintigraphy is the pivotal examination. Normal colloid uptake by a focal hepatic mass is virtually diagnostic. However, in the patients in whom the colloid scan shows decreased or absent uptake, angiography may show findings diagnostic of focal nodular hyperplasia in up to 75% of cases, thus avoiding the need need for liver biopsy or surgery.