Low-Grade Siderotic Dysplastic Nodules

Improved Siderotic Nodule Detection in Cirrhosis with Susceptibility-Weighted Magnetic Resonance Imaging: A Prospective Study

“…Hepatic iron content is a known risk factor for developing hepatocellular carcinoma (HCC). While the association between grades of siderotic dysplastic nodules and malignancy has not been established, siderotic dysplastic nodules are thought to represent premalignant lesions [15], [16], [20], [21]. MRI has been used to grade siderotic nodules, and nodule grade and number have been shown to be significantly correlated with periportal inflammatory activity in cirrhotic patients [33].…”

“…Magnetic resonance imaging is currently unable to differentiate siderotic regenerative nodules from siderotic dysplastic nodules [19]. The association of siderotic nodules and malignancy remains controversial; some studies reported no increase in dysplastic nodules or hepatocellular carcinoma in patients with siderotic nodules [15], [20] but others have reported that siderotic nodules can be precursors of primary hepatocellular carcinomas in patients with chronic liver diseases [21]–[23], and that the incidence of hepatocellular carcinomas is higher in patients with iron-containing nodules than in those without iron-containing nodules [23]. Iron-free foci were found in siderotic macroregenerative nodules in liver cirrhosis, and these foci were classic and overt carcinoma or borderline lesions showing an expansive growth pattern [15].…”

The role of contrast-enhanced ultrasound in the detection of focal liver leasions

“…In addition, paramagnetic hepatocytespecific contrast agents are showing promise in their ability to improve detection of HCC [32,33]. However, despite substantial technological improvements in MRI and CT over the past decade, detection of small (less than 2 cm) HCCs still remains a significant challenge [34].…”