Nodular regenerative hyperplasia in the setting of Budd-Chiari syndrome: Application of MR with hepatobiliary contrast agents and histologic confirmation
Overview: Nodular regenerative hyperplasia in the setting of Budd-Chiari syndrome is an uncommon benign finding but critical to diagnose accurately. Its imaging appearance of hyperenhancing lesions on arterial phase imaging on a background of chronic liver disease can raise concern for neoplastic etiologies such as hepatocellular carcinoma. However, the imaging appearance of these lesions on delayed hepatobiliary phase imaging with hepatobiliary MR contrast agents can be extremely useful in excluding hepatocellular carcinoma from the differential diagnosis and confirming nodular regenerative hyperplasia. The findings on histologic examination can also be helpful in understanding the reason for the hyperintensity of these lesions on delayed phase imaging with these hepatobiliary MR contrast agents.
