Liver lesion. >1.5 cm. Suspicious or “flash-filling” features.

 

Is this a low-risk patient or high-risk patient for having a malignant hepatic lesion?

Low risk.            

High risk.

Risk unknown (inadequate clinical information).

 

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Notes:

Low-risk patients: No known malignancy. No hepatic dysfunction. No hepatic risk factors.
High-risk patients: Known malignancy with a propensity to metastasize to the liver. Cirrhosis. Presence of hepatic risk factors.
Hepatic risk factors: hepatitis, nonalcoholic steatohepatitis, alcoholism, sclerosing cholangitis, primary biliary cirrhosis, choledochal cysts, hemochromatosis and other hereditary hepatic conditions, and anabolic steroid use.

If the primary concern is to differentiate between FNH and adenoma, especially if the lesion is >3 cm and subcapsular in location, MRI with Eovist is advised.