IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Focal nodular hyperplasia

Case contributed by Hein Els
Diagnosis possible

Presentation

Abdominal pain

Patient Data

Gender: Female
ultrasound

Circumscribed hypoechoic lesion in the right lobe of the liver. Doppler shows prominent vascular structures in the lesion creating a spoke wheel appearance, confirmed at contrast enhanced ultrasound (CEUS). The lesion shows centrifugal enhancement. 

Case Discussion

CEUS is more sensitive than CT or MR at demonstrating the spoke wheel sign. The sign is highly suggestive of FNH, but scirrhous hepatocellular carcinoma may also demonstrate this sign at CEUS and should be included in the differential diagnosis for lesions with a spoke wheel sign shown at CEUS.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.