Abstract
IntroductionComputed tomography and magnetic resonance imaging are able to demonstrate and to diagnose hepatic focal nodular hyperplasia when a typical pattern of a well-circumscribed lesion with a central scar is present.Our aim is to propose the split-bolus multidetector-row computed tomography technique as an alternative to the conventional triphasic technique in the detection and characterization of focal nodular hyperplasia to reduce the radiation dose to the patient.To the best of our knowledge, this is the first report regarding the application of the split-bolus computed tomography technique in the evaluation of hepatic focal nodular hyperplasia.Case presentationWe describe a case of focal nodular hyperplasia of the liver in a 53-year-old Caucasian woman (weight 75Kg) with a colorectal adenocarcinoma histologically confirmed. An innovative split-bolus multidetector-row computed tomography technique was used that, by splitting intravenous contrast material in two boli, combined two phases (hepatic arterial phase and portal venous phase) in a single pass; a delayed (5 minutes) phase was obtained to compare the findings with that of triphasic multidetector-row computed tomography.ConclusionsSplit-bolus multidetector-row computed tomography was able to show the same appearance of the lesion as the triphasic multidetector-row computed tomography technique.This is the first case demonstrating the effectiveness of the split-bolus multidetector-row computed tomography technique in the detection and characterization of focal nodular hyperplasia with a significant reduction in radiation dose to the patient with respect to triphasic multidetector-row computed tomography technique.
Highlights
Computed tomography and magnetic resonance imaging are able to demonstrate and to diagnose hepatic focal nodular hyperplasia when a typical pattern of a well-circumscribed lesion with a central scar is present
Split-bolus multidetector-row computed tomography was able to show the same appearance of the lesion as the triphasic multidetector-row computed tomography technique
This is the first case demonstrating the effectiveness of the split-bolus multidetector-row computed tomography technique in the detection and characterization of focal nodular hyperplasia with a significant reduction in radiation dose to the patient with respect to triphasic multidetector-row computed tomography technique
Summary
Computed tomography and magnetic resonance imaging are able to demonstrate and to diagnose hepatic focal nodular hyperplasia when a typical pattern of a well-circumscribed lesion with a central scar is present. An innovative split-bolus multidetector-row computed tomography technique was used that, by splitting intravenous contrast material in two boli, combined two phases (hepatic arterial phase and portal venous phase) in a single pass; a delayed (5 minutes) phase was obtained to compare the findings with that of triphasic multidetector-row computed tomography. Triphasic helical computed tomography (CT) scans – hepatic arterial phase (HAP), portal venous phase (PVP) and delayed phase (DP) – represent an accurate technique in the characterization of typical FNH [4]. Split-bolus protocol is an innovative technique that, by splitting intravenous contrast medium into two boli and combining phase images in a single scan, is used in several CT applications [5,6]
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