Which imaging feature is most characteristic of focal nodular hyperplasia?

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Multiple Choice

Which imaging feature is most characteristic of focal nodular hyperplasia?

Focal nodular hyperplasia is best identified by a central scar on imaging. That central scar represents fibrous tissue with radiating septa and is the most distinctive feature that sets FNH apart from other hepatic lesions. On imaging, you often see a lesion with arterial-phase enhancement due to a feeding artery, and the central scar may enhance in the delayed phase because fibrous tissue takes up contrast later. This combination—central scar plus the typical enhancement pattern—is what makes FNH stand out. For context, peripheral nodular enhancement with progressive fill-in points to cavernous hemangioma, rapid washout suggests hepatocellular carcinoma or certain adenomas, and a calcified rim isn’t a characteristic hallmark of FNH.

Focal nodular hyperplasia is best identified by a central scar on imaging. That central scar represents fibrous tissue with radiating septa and is the most distinctive feature that sets FNH apart from other hepatic lesions. On imaging, you often see a lesion with arterial-phase enhancement due to a feeding artery, and the central scar may enhance in the delayed phase because fibrous tissue takes up contrast later. This combination—central scar plus the typical enhancement pattern—is what makes FNH stand out.

For context, peripheral nodular enhancement with progressive fill-in points to cavernous hemangioma, rapid washout suggests hepatocellular carcinoma or certain adenomas, and a calcified rim isn’t a characteristic hallmark of FNH.

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