What are the classic MRI features of focal nodular hyperplasia?

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FNH classic MRI features center on its vascular and fibrous architecture. These lesions are well supplied by hepatic arteries, so they show strong enhancement in the arterial phase. That enhancement often persists into the portal and delayed phases, so the lesion remains conspicuous on later images. A central scar is a hallmark: fibrous tissue in the center typically appears T2-bright and, importantly, enhances on delayed imaging as the scar takes up contrast slowly. Taken together, the combination of arterial-phase enhancement with persistence on later phases and a central scar that enhances on delayed imaging is characteristic for focal nodular hyperplasia. In practice, hepatobiliary contrast agents can further support the diagnosis, as FNH often shows uptake in the hepatocyte-rich tissue, unlike many other focal liver lesions.