Macro regenerating nodule in the cirrhotic liver. Radiologic features and differential diagnosis

The radiologic features and the differential diagnosis of the large macroregenerating nodule in the cirrhotic liver are described as visualized in 7 patients, 6 of whom had large nodular livers. Two coexisting patterns predominate: the cirrhotic pattern with its tortuous, compressed and corkscrew appearance; and the pattern associated with the regenerating nodules demonstrating large stretched hepatic artery vessels containing a few side branches. The hepatic scan most often demonstrates an irregular distribution with decreased to normal activity throughout the liver. The findings depend on the distribution of the underlying diseased state. Correlation of the scan and the hepatic arteriogram are necessary to avoid falsely diagnosing space occupying masses in either study. The findings then recognized are relatively specific. Since the cirrhotic liver is capable at one time of forming either large regenerating nodules or hepatoma, it is important to recognize the presence of a regenerating nodule in an enlarged liver, in order to avoid unnecessary surgery.