ACE inhibition reduces left ventricular mass independent of pressure without affecting coronary flow and flow reserve in spontaneously hypertensive rats

Systemic and regional (including coronary) hemodynamics were studied in spontaneously hypertensive and normotensive Wistar Kyoto rats after 3 weeks of treatment with one of the three doses of the angiotensin converting enzyme inhibitor, ramipril. The effects of respective treatments on cardiovascular mass and systemic, coronary, and regional hemodynamics (at rest, during maximal treadmill exercise, and during dipyridamole infusion) then were evaluated in conscious rats using radiomicrosphere techniques. Low-dose ramipril (10 micrograms/kg/day by gavage) neither decreased arterial pressure nor reduced cardiac mass. However, medium (100 micrograms/kg/day) and high (1 mg/kg/day) doses reduced total cardiac and left ventricular masses to the same extent in spontaneously hypertensive rats, despite a much greater fall in arterial pressure with a high dose. Resting cardiac index, and myocardial and all other organ blood flows remained unchanged in both strains. When compared with Wistar Kyoto rats, coronary circulation was impaired in untreated spontaneously hypertensive rats (ie, reduced coronary flow and flow reserve and increased minimal coronary vascular resistance during dipyridamole infusion). This remained unchanged by ramipril. Furthermore, significant (and comparable) increases in cardiac index and myocardial blood flow and decreases in coronary vascular resistance were produced by maximal treadmill exercise in both strains. This also was unaffected by ramipril. These data showed that angiotensin converting enzyme inhibition with suboptimal and optimal hypotensive doses of ramipril reversed left ventricular hypertrophy in spontaneously hypertensive rats, but coronary flow, flow reserve, and minimal coronary vascular resistance remained unchanged despite left ventricular hypertrophy reversal.

Does Decrease in Ribulose-1,5-Bisphosphate Carboxylase by Antisense RbcS Lead to a Higher N-Use Efficiency of Photosynthesis under Conditions of Saturating CO2 and Light in Rice Plants?

Rice (Oryza sativa L.) plants with decreased ribulose-1,5-bisphosphate carboxylase (Rubisco) were obtained by transformation with the rice rbcS antisense gene under the control of the rice rbcS promoter. The primary transformants were screened for the Rubisco to leaf N ratio, and the transformant with 65% wild-type Rubisco was selected as a plant set with optimal Rubisco content at saturating CO2 partial pressures for photosynthesis under conditions of high irradiance and 25[deg]C. This optimal Rubisco content was estimated from the amounts and kinetic constants of Rubisco and the gas-exchange data. The R1 selfed progeny of the selected transformant were grown hydroponically with different N concentrations. Rubisco content in the R1 population was distributed into two groups: 56 plants had about 65% wild-type Rubisco, whereas 23 plants were very similar to the wild type. Although the plants with decreased Rubisco showed 20% lower rates of light-saturated photosynthesis in normal air (36 Pa CO2), they had 5 to 15% higher rates of photosynthesis in elevated partial pressures of CO2, (100-115 Pa CO2) than the wild-type plants for a given leaf N content. We conclude that the rice plants with 65% wild-type Rubisco show a higher N-use efficiency of photosynthesis under conditions of saturating CO2 and high irradiance.

Complement partially mediates acid aspiration-induced remote organ injury in the rat

BACKGROUND

Acid aspiration into one lung is known to cause both a local as well as remote organ injury characterized by neutrophil sequestration and subsequent edema. This study investigated investigated the role of the complement cascade in the development of acid aspiration-induced local lung and remote organ injuries using K-76 COONa (K76), an anticomplement agent that inhibits the complement pathway at the C5 step, and its usefulness as a treatment drug.

METHODS

Anesthetized rats underwent tracheostomy and insertion of a cannula. K76 was intraperitoneally administrated prior to or immediately after the instillation of 0.1 ml of HCl (0.1N) or phosphate buffer solution (PBS) into the left lung. Inflammatory responses were evaluated by tumor necrosis factor alpha (TNF alpha) in the plasma and the bronchoalveolar lavage fluid (BALF) (n = 4), tissue myeloperoxidase (MPO), wet-to-dry weight ratio (W/D ratio) (n = 6), and protein concentration in the BALF (n = 6).

RESULTS

Acid instillation caused an increase in the plasma TNF alpha, which was significantly attenuated by the administration of K76 prior to or after the acid instillation. Acid instillation to the left lung resulted in an increase of MPO and W/D ratios of the left lung, the right lung, and the small intestine. The administration of K76 inhibited the increase of MPO in these organs. K76 inhibited the increase of W/D ratios of the right non-instillated lung and the small intestine. Acid instillation led to increased protein concentration in the BALF of the left lung, which was not inhibited by K76. K76 administrated after the acid instillation had the same effects. TNF alpha in the BALF was not detected in all groups.

CONCLUSION

These results suggest that localized acid aspiration induces, through the C5a step of the complement system-dependent mechanisms, TNF alpha formation and neutrophil sequestration, which caused the increase of endothelial permeability of the systemic organs. K76 is effective as a treatment drug in modulating some of the injuries caused by the acid instillation, but further investigations is warranted as to its potential as a therapeutic agent.

Operative treatment of congenital stenoses of the intrahepatic bile ducts in patients with choledochal cysts

BACKGROUND

Postoperative complications including intrahepatic calculi may develop after the complete excision of a choledochal cyst. Since congenital stenoses of the intrahepatic bile ducts are more likely the cause of intrahepatic calculi, operative procedures for intrahepatic stenoses are reported.

METHODS

There were 16 patients with choledochal cysts who underwent surgery for stenoses of intrahepatic bile ducts. The stenoses were excised at the opening of the common hepatic duct.

RESULTS

In the 16 patients, 25 of the 26 stenoses that involved an intraluminal membrane or septum could be excised from the divided end of the common hepatic duct at the hepatic hilum. In 1 patient, the stenosis could not be accessed from the hepatic hilum, and a left hepatic lobectomy was required. In postoperative follow-up, all 16 patients were in good health.

CONCLUSIONS

Stenoses of the intrahepatic bile ducts should be treated from the divided end of the common hepatic duct at the initial operation for choledochal cysts. The need for a second operation or hepatic lobectomy may thus be avoided.

Impact of natural IRS-1 mutations on insulin signals: mutations of IRS-1 in the PTB domain and near SH2 protein binding sites result in impaired function at different steps of IRS-1 signaling

Insulin receptor substrate-1 (IRS-1) is one of the major substrates of insulin receptor tyrosine kinase and mediates various insulin signals downstream. In this study, we have examined the impact of three natural IRS-1 mutations identified in NIDDM patients (G971R, P170R, and M209T) on insulin signaling. G971R is located near src homology 2 protein binding sites, and P170R and M209T are located in the phosphotyrosine binding domain of IRS-1. 32D-IR cells, stably overexpressing human insulin receptor, were transfected with wild-type human IRS-1 cDNA (WT) or three mutant IRS-1 cDNAs and analyzed. All the cell lines expressing mutant IRS-1 showed a significant reduction in [3H]thymidine incorporation compared with WT. Upon insulin stimulation, cells expressing G971R showed a 39% decrease (P < 0.005) in phosphatidylinositol 3-kinase (PI 3-kinase) activity, a 43% decrease (P < 0.01) in binding of the 85-kDa regulatory subunit of PI 3-kinase, and a 22% decrease (P < 0.05) in mitogen-activated protein kinase activity compared with those expressing WT. Cells expressing P170R and M209T showed slight but significant decreases in PI 3-kinase activity (17 and 14%, respectively; both P < 0.05) and in binding of p85 (22 and 16%, respectively; both P < 0.05) and a greater decrease in mitogen-activated protein kinase activity (41 and 43%, respectively; both P < 0.005) compared with WT. After insulin stimulation, cells expressing P170R and M209T showed significant decreases in IRS-1 phosphorylation (37 and 42%, respectively; both P < 0.05) and in IRS-1 binding to the insulin receptor (48 and 53%, respectively; P < 0.01) compared with WT. G971R showed no changes in IRS-1 phosphorylation and in IRS-1 binding to the insulin receptor compared with WT. These data suggest that the impaired mitogenic response of P170R and M209T was mainly due to reduced binding to the insulin receptor, whereas the impaired response of G971R was mainly due to reduced association with PI 3-kinase p85.

Protein plugs cause symptoms in patients with choledochal cysts

OBJECTIVES

Symptoms in patients with choledochal cysts are believed to be caused by pancreaticobiliary maljunction. However, this anomaly alone cannot explain the occurrence of symptoms. The aim of this study was to elucidate the etiology of the symptomatology in patients with choledochal cysts.

METHODS

Clinical data and preoperative and operative cholangiopancreatography were reviewed in 55 consecutive patients with choledochal cysts seen between 1980 and 1996.

RESULTS

The bile duct was significantly larger in the symptomatic phase than in the asymptomatic phase. External biliary drainage resulted in rapid resolution of symptoms in 11 patients. A radiolucent filling defect in the pancreaticobiliary duct was found in 22 patients (40.0%). The defects were in the common channel in 15 patients and near the common channel in 7 patients. Filling defects disappeared spontaneously or after irrigation in 19 patients. In three patients, the material in the common channel removed during surgery was fragile and consisted of more than 98% protein.

CONCLUSION

The filling defects were protein plugs. The simultaneous occurrence of symptoms and signs may be explained by disturbances in bile and pancreatic secretory flow caused by a protein plug in the common channel.

Treatment of hepatic encephalopathy by retrograde transcaval coil embolization of an ileal vein-to-right gonadal vein portosystemic shunt

A 43-year-old non-cirrhotic woman suffered from encephalopathy caused by an extrahepatic portosystemic shunt between the ileal vein and inferior vena cava via the right gonadal vein. Percutaneous transcatheter embolization with stainless steel coils was performed by the retrograde systemic venous approach. Encephalopathy improved dramatically.

Effect of coil position and stimulus intensity in transcranial magnetic stimulation on human brain

Evoked spinal cord potentials (ESCPs) from the cervical and high thoracic epidural space following transcranial magnetic stimulation were recorded from eight subjects in awake and anesthetized condition. Motor evoked potentials (MEPs) from the right abductor digiti minimi (ADM) and rectus femoris (RF) muscles were simultaneously recorded during voluntary contraction. The stimulus intensity was at 30% above the MEPs threshold of the ADM when the coil center was fixed on 10-20 international Cz position. In awake condition, multiple ESCP components (greater than 3) were recorded from the cervical epidural space but no or minimal components were recorded from the upper thoracic epidural space. When the coil was moved anteriorly so that the posterior edge of the coil was positioned on Cz, the amplitude of the first ESCP component was significantly increased (P < 0.02) and shortened (not significant) at cervical levels. In addition, several ESCP components were more evident at high thoracic levels. Although the amplitude of the ADM was not enhanced, that of the RF was enhanced. During general anesthesia with volatile anesthetics (sevoflurane), only the first component of the ESCPs (D-wave) was elicited. Its amplitude was enhanced (P < 0.02) when the coil edge was fixed on Cz, similar to results in awake condition. This enhancement of the first ESCP component was accompanied by enhancement of those recorded from the high thoracic epidural space. However the amplitude of D-wave was the same in the two different coil positions when the stimulus intensity was set a 100% of the output. These results suggest that at low stimulus intensity, positioning the coil edge on Cz is optimal in inducing D-wave effectively but at high stimulus intensity, D-wave generation can be achieved in either if the two different coil position.

Developmental acquisition of enhancer function requires a unique coactivator activity

Enhancers are believed to stimulate promoters by relieving chromatin-mediated repression. However, injection of plasmid-encoded genes into mouse oocytes and embryos revealed that enhancers failed to stimulate promoters prior to formation of a two-cell embryo, even though the promoter was repressed in the maternal nucleus of both oocytes and one-cell embryos. The absence of enhancer function was not due to the absence of a required sequence-specific enhancer activation protein, because enhancer function was not elicited even when these proteins either were provided by an expression vector (GAL4:VP16) or were present as an endogenous transcription factor (TEF-1) and shown to be active in stimulating promoters. Instead, enhancer function in vivo required a unique coactivator activity in addition to enhancer-specific DNA binding proteins and promoter repression. This coactivator activity first appeared during mouse development in two- to four-cell embryos, concurrent with the major onset of zygotic gene expression. Competition between various enhancers was observed in these embryos, but not competition between enhancers and promoters, and competition between enhancers was absent in one-cell embryos. Moreover, enhancer function in oocytes could be partially restored by pre-injecting mRNA from cells in which enhancers were active, the same mRNA did not affect enhancer function in two- to four-cell embryos.

[A case of right ventricular myxoma]

A 43-year-old male presented with a history of occasional syncopal episodes and general fatigue for 4 months. On admission, a grade 4/6 systolic murmur was noted, and the electrocardiogram demonstrated frequent premature supraventricular beats. An echocardiogram revealed the presence of a multi-lobular mass in the right ventricle which prolapsed into the pulmonary artery during systole. Ultrafast computed tomography demonstrated a pedunculated mass arising from the right ventricular free well. At operation, the soft mass was excised through the tricuspid valve under cardiac arrest. Histopathologically, the tumor was diagnosed as a myxoma. Myxoma of the right ventricle occurs very rare. We review the literature relevant to cardiac myxoma.

Morphology of capillary-like structures in a three-dimensional aorta/collagen gel culture

The morphology of capillary-like tubes was investigated by electron microscopy (TEM and SEM) using an in vitro model of capillarogenesis (aorta/collagen type I gel). This model allowed morphological comparisons with in vivo capillaries and an evaluation of the functional maturity of the endothelium to be made. The lumina developing in vitro were demarcated by endothelial cells of varying thickness (0.1-2 microns). Pericytes were resting on the outside. The endothelial cells were characterized by contacts of varying length with tight and gap junctions and occasional indentations. The inner surface exhibited areas both with pronounced and without any endocytotic activity. In addition to a large Golgi apparatus, a varying number of cell organelles occurred depending on the thickness of the endothelium. Bundles consisting of microfilaments were often located underneath the outer cell membrane and in the vicinity of contact areas. A lamina densa was in the process of formation. The capillaries grown in vitro closely resembled those in vivo and showed a high degree of differentiation. Hence, this in vitro model allows the study of a number of functions of endothelial cells.

Formation of new capillary-like tubes in a three-dimensional in vitro model (aorta/collagen gel)

Direct sprouting (angiogenesis) does not occur during the formation of capillary-like tubes in an aorta/ collagen gel in the in vitro model. However, emigration of cells which stretch, arrange themselves side by side, form contacts (unspecific, tight and gap junctions), develop a lumen and show differentiation of endothelial cells (including the formation of a lamina densa and the appearance of pericytes) have been observed, i.e. vasculogenesis occurs. The origin of long, stretched cells is not known with certainty. They possibly represent smooth muscle cells. In addition, other cell types have been found, such as fibrocyte-like and fibroblast-like cells, elastoblasts, fat cells, monocytes and macrophages. All these cells are able to produce factors that promote the formation of new capillaries. Hence, a knowledge of these cells appears to be important for the analysis of in vitro systems. Moreover, the occurrence of these cell types must be considered when assessing possible effects.

COOH-terminal sequence of the cellular prion protein directs subcellular trafficking and controls conversion into the scrapie isoform

Efficient formation of scrapie isoform of prion protein (PrP(Sc)) requires targeting PrP(Sc) by glycophosphatidyl inositol (GPI) anchors to caveolae-like domains (CLDs). Redirecting the cellular isoform of prion protein (PrP(C)) to clathrin-coated pits by creating chimeric PrP molecules with four different COOH-terminal transmembrane domains prevented the formation of PrP(Sc). To determine if these COOH-terminal transmembrane segments prevented PrP(C) from refolding into PrP(Sc) by altering the structure of the polypeptide, we fused the 28-aa COOH termini from the Qa protein. Two COOH-terminal Qa segments differing by a single residue direct the transmembrane protein to clathrin-coated pits or the GPI form to CLDs; PrP(Sc) was formed from GPI-anchored PrP(C) but not from transmembrane PrP(C). Our findings argue that PrP(Sc) formation is restricted to a specific subcellular compartment and as such, it is likely to involve auxiliary macromolecules found within CLDs.

Coexisting peripheral nerve and cervical cord compression

STUDY DESIGN

The authors investigated the clinical usefulness of recording motor evoked potentials after transcranial magnetic stimulation in coexisting peripheral nerve and cervical cord lesions.

OBJECTIVE

To show that the measurement of central motor conduction time from the abductor policis brevis and the abductor digiti minimi can be used as a good screening method for double lesions involving peripheral nerves and the cervical cord.

SUMMARY OF BACKGROUND DATA

Transcranial magnetic stimulation has been used in the diagnosis of compressive cervical myelopathy. This technique could be useful in the assessment of patients with an entrapment neuropathy and cervical myelopathy.

METHODS

Motor evoked potentials after transcranial magnetic stimulation, compound muscle action potentials, and F waves after supramaximal peripheral nerve stimulation were recorded from the abductor policis brevis and the abductor digiti minimi. The central motor conduction time was calculated by subtracting the peripheral conduction time from the motor evoked potentials latency.

RESULTS

Ten patients with coexisting peripheral nerve and cervical cord lesions were evaluated. Two patients did not show satisfactory improvement after the decompression of the entrapment lesions, and six patients had hyperreflexia of lower limbs. In seven of these patients, the central motor conduction time was prolonged an average of 2.5 standard deviation of the normal value. The remaining two patients had spinal cord compression due to the ossification of the posterior longitudinal ligament. The spinal cord compression was demonstrated by magnetic resonance imaging, but the central motor conduction time was normal. Subjective symptoms improved in these two patients after decompressive surgery at the entrapment site alone.

CONCLUSIONS

Measurement of the central motor conduction time using motor evoked potentials is an ideal diagnostic approach for patients with coexisting entrapment neuropathy and cervical cord compression.

Cell-specific regulation of IRS-1 gene expression: role of E box and C/EBP binding site in HepG2 cells and CHO cells

Insulin receptor substrate 1 (IRS-1) is one of the major substrates of insulin receptor tyrosine kinase and mediates multiple insulin signals downstream. We have previously shown that the levels of IRS-1 mRNA varied in different tissues. To elucidate the molecular mechanisms of the tissue specific regulation of IRS-1, we have studied the cis-acting elements and transacting factors in CHO and HepG2 cells. Using the chloramphenicol acetyltransferase (CAT) assay with the various deletion mutants of the IRS-1 promoter-CAT fusion plasmids, several regions responsible for positive or negative regulation in each cell line were identified. A region from -1645 to -1585 bp, which regulated expression negatively in CHO cells and positively in HepG2 cells, was further analyzed. Within this region a fragment from -1645 to -1605 bp upregulated the IRS-1 promoter only in HepG2 cells, whereas a fragment from -1605 to -1585 bp downregulated only in CHO cells. In the gel mobility shift assay, several nuclear proteins that bind to these fragments were detected, and among them, two nuclear proteins that bind to a potential E box (nucleotide [nt] -1635 to -1630) and two nuclear proteins that bind to a potential C/EBP binding site (nt -1599 to -1591) were identified in HepG2 and CHO cells, respectively. CAT assays using promoters mutated at the E box or at the C/EBP binding site revealed that these sequences were responsible for cell-specific regulation of the IRS-1 gene. We therefore concluded that the two nuclear proteins that bind to the E box regulate IRS-1 gene expression positively in HepG2 cells and the two nuclear proteins that bind to the C/EBP binding site regulate it negatively in CHO cells.

Anatomy of the round ligament in female infants and children with an inguinal hernia

BACKGROUND

The ligament which runs along an inguinal hernia sac in females is believed to be the round ligament of the uterus. According to most standard textbooks, the round ligament of the uterus terminates at the labium majorum. This study examined the termination of the ligament.

METHODS

The anatomy of the ligament was examined in 248 female children (aged 1 month to 11 years) with an inguinal hernia. The anterior wall of the hernia sac, consisting of the inner and outer membranes, was opened and the inner membrane of the sac was pulled up with forceps; the hernia sac was then separated from the surrounding tissue. The termination of the ligament was observed.

RESULTS

The ligament did not end at the labium majorum but terminated in the hernia sac. The ligament was attached to the mid portion of the fallopian tube near the ovary.

CONCLUSION

These findings suggest that the ligament which runs along the hernia sac is the suspensory ligament of the ovary.

Small hepatocellular carcinoma on magnetic resonance imaging. Relation of signal intensity to angiographic and clinicopathologic findings

RATIONALE AND OBJECTIVES

The authors discuss the clinicopathologic features and angiographic vascularity of various signal intensity patterns on magnetic resonance (MR) imaging of small hepatocellular carcinomas (HCCs).

METHODS

Magnetic resonance images of 88 resected HCCs (< or = 3 cm) were obtained using T1- and T2-weighted spin-echo images and T1-weighted images after gadolinium (Gd)-DTPA administration. Images were compared with angiographic and histopathologic findings.

RESULTS

Forty HCCs (45%) were depicted on T1-weighted images, 51 (58%) on T2-weighted images, and 41 (49%) on T1-weighted images after Gd-DTPA administration. Overall, 64 (76%) were found on at least one image. On T1-weighted images, hyperintense HCCs histologically showed fatty metamorphosis and portal tracts within the tumor. On T2-weighted images, HCC hyperintensity correlated with expansive growth, peliotic change, and hypervascularity. By contrast, HCCs that were undetected or hypointense on T2-weighted images were well differentiated with replacing growth and portal tracts. On T1-weighted images after Gd-DTPA, hyperintense HCCs had peliotic change; undetected HCCs were well differentiated and hypovascular.

CONCLUSIONS

Histologic grade, vascularity, portal tracts and peliotic change correlate with MR signal intensity. For hyperintense HCCs on T1-weighted images and hypo- or isointense HCCs on T2-weighted images, treatment methods must be assigned with the consideration that HCCs may be receiving transsinusoidal and portal blood supplies.

Helical CT evaluation of arterial invasion in pancreatic tumors: comparison with angiography

BACKGROUND

Although helical computed tomography (HCT) has been widely employed for the evaluation of pancreatic tumors, its capability in the diagnosis of peripancreatic arterial invasion has not been established.

METHODS

HCT with a sequential cine-display was carried out in 34 patients with solid pancreatic tumors and 28 control subjects without angiographic abnormality. The HCT scans were compared with angiograms.

RESULTS

All major arteries (celiac, superior mesenteric, splenic, gastroduodenal) and superoanterior pancreaticoduodenal arteries were well demonstrated by HCT in control subjects. However, posterior pancreaticoduodenal arcades and other smaller arteries were poorly identified. Although 19 major arterial invasions were equally diagnosed by HCT and angiography in patients with pancreatic tumors, only 4 of 11 minor arterial invasions were correctly diagnosed by HCT.

CONCLUSIONS

Although HCT has some limitations in the evaluation of minor peripancreatic arteries, it can provide enough information for making a decision about conducting pancreatic surgery.

Efficacy of helical CT in T-staging of gastric cancer

PURPOSE

The purpose of this study was to evaluate the performance of helical CT in preoperative T-staging in patients with gastric cancer.

METHOD

A total of 71 patients with an established diagnosis of gastric cancer [75 lesions, 46 early (T1) and 29 advanced (T2 or more) cancers] were evaluated with helical CT. Helical CT was performed with 5-mm slice thickness at 5-mm/s table incrementation. Using the volumetric data by helical scanning, axial CT images (5-mm slice thickness at 5-mm intervals) and multiplanar reconstruction (MPR) images were obtained. CT findings were compared with histopathologic studies of the resected specimen.

RESULTS

Sensitivity of helical CT for gastric cancer was 26% (12 of 46) for early and 100% (29 of 29) for advanced cancer. Three lesions were misdiagnosed as gastric cancer by helical CT. Histopathologically, all early gastric cancers detected by helical CT were either polypoid or elevated types or showed massive invasion of the submucosal layer. The differentiation between T1 cancer with massive submucosal invasion and advanced cancer was difficult. The differentiation between T2 and T3 cancer was possible in 73% (19 of 26) and between T1/T2 and T3/T4 (extraserosal invasion) in 83% (34 of 41). Overall T-staging was correct in 66% (27 of 41). MPR images improved the detection rate (three lesions) or increased confidence in T-staging (eight lesions) over axial CT images.

CONCLUSION

When helical CT detected gastric cancer that was not a polypoid or elevated type with underlying normal-appearing gastric wall, it was either T1 cancer with massive invasion of the cancer cells into the submucosal layer or advanced cancer. However, differentiation between these two stages was difficult on CT. Diagnosis of serosal invasion was not markedly improved by helical CT. MPR images increased confidence in the staging of certain gastric cancers, such as those in locations where CT images are susceptible to partial volume averaging effects.

MR imaging of focal nodular hyperplasia of the liver: value of contrast-enhanced dynamic study

To clarify the role of MR imaging of hepatic focal nodular hyperplasia (FNH), MR images of 11 patients with 13 FNH were retrospectively reviewed. MR imaging with T1- and T2-weighted spin echo sequences was performed for all lesions. Dynamic studies using the SPGR technique followed by postcontrast delayed T1-weighted images were performed in four patients with five lesions. Gd-DTPA enhanced T1-weighted images were obtained in five patients with six lesions. Two patients with single lesions received no contrast agent. The signal intensity, morphologic appearance, and enhancement patterns were evaluated. Dynamic MR study revealed homogeneous early vigorous enhancement and prolonged enhancement in all five lesions. On T1-weighted images, three lesions were hypointense, six were isointense, and four were hyperintense to the surrounding hepatic parenchyma. On T2-weighted images, four lesions were isointense and nine were hyperintense. A central scar was identified in eight lesions and showed delayed enhancement. It is concluded that dynamic MR studies are mandatory for diagnosing FNH.