Case 148:   Cirrhosis

Diagnostic Category:

Clinical Presentation:

22 year old woman with toxin-induced hepatic injury due to recent alcohol use and ingestion of hallucinogenic mushrooms.

CT: Regenerative nodules, isovascular, central vessel; toxin induced hepatic injury

Imaging Findings:

Biopsy proven focal acute hepatitis with architectural disarray and reactive/regenerative changes. CT shows large regenerative nodules (RN) peripherally and severe confluent fibrosis centrally with fibrotic delayed enhancement on equilibrium phase. Note that the unenhanced appearance of the RN here is hyperdense relative to the fibrotic parenchyma centrally in the liver. Penetrating vessels (arrowheads) within the RN differentiate them from neoplasms.