Fig. 1

A 62-year-old male patient with positive HCV and accidentally discovered HFL by US. A Axial T2 image shows a large right hepatic lobe mass (blue arrow) and a smaller one at segment IV (orange arrow). B axial diffusion and C ADC images showed restricted diffusion with ADC value 1.1 for the large lesion and 1.05 for the smaller one D Axial DTI gray scale image, E DTI-ADC map and F FA map: the ADC value is 0.66 for the large lesion and 0.61 for the smaller one which is lower than conventional ADC and the FA value was high (0.55 for the large lesion and 0.58 for the smaller one). G Non-contrast T1 H arterial phase and I delayed phase of the dynamic study showed faint heterogeneous arterial enhancement of the smaller lesion while no significant enhancement within the larger one and both show delayed wash out and enhancing capsule; also, there is an eccentric hemorrhagic area in the larger lesion, and imaging features were compatible with HCC. The large lesion was categorized as LR 4 (due to lack of arterial hyperenhancement) and the smaller lesion was categorized as LR 5. Another small subcapsular focal lesion is also noted at left lobe segment II showing arterial enhancement with no diffusion restriction or delayed wash out, this was categorized as LR 3 (probably a dysplastic nodule), the FA value was 0.36, the DTI-ADC was 0.81 and the diffusion ADC was 1.2