Focal Nodular Hyperplasia is best described by which imaging feature?

Focal Nodular Hyperplasia is best described by which imaging feature?

• A. It commonly shows a central scar with radial vascularity
• B. It is always encapsulated
• C. It frequently has elevated LFTs
• D. It is most common in men over 60

Answer: (A)

The imaging hallmark of focal nodular hyperplasia is a central scar with radial (spoke-wheel) vascularity. This benign lesion has a central fibrous scar surrounded by proliferating hepatocytes and fibrous septa fed by multiple feeding vessels. On imaging, you often see a well-circumscribed lesion with a central scar, and Doppler commonly reveals vessels radiating outward from the center, giving a spoke-wheel pattern. In contrast-enhanced studies, the lesion typically enhances rapidly in the arterial phase due to its arterial blood supply, while the central scar may remain hypovascular or enhance on delayed phases because of fibrous tissue. This combination—central scar plus radial vascularity—is the characteristic feature. LFTs are usually normal, and it is more common in women of reproductive age, not men over 60, and it is not typically encapsulated.

The imaging hallmark of focal nodular hyperplasia is a central scar with radial (spoke-wheel) vascularity. This benign lesion has a central fibrous scar surrounded by proliferating hepatocytes and fibrous septa fed by multiple feeding vessels. On imaging, you often see a well-circumscribed lesion with a central scar, and Doppler commonly reveals vessels radiating outward from the center, giving a spoke-wheel pattern. In contrast-enhanced studies, the lesion typically enhances rapidly in the arterial phase due to its arterial blood supply, while the central scar may remain hypovascular or enhance on delayed phases because of fibrous tissue. This combination—central scar plus radial vascularity—is the characteristic feature. LFTs are usually normal, and it is more common in women of reproductive age, not men over 60, and it is not typically encapsulated.