Figure 2. a–c.

Axial T2-weighted (a), venous phase T1-weighted (b), and 20-min T1-weighted (c) MR images of a patient with the “spoke wheel” aspect that is typical for FNH. A central scar with divergences to the periphery is visible on T2-weighting and is reminiscent of a “spoke wheel” (a). These so-called spokes are normally enhanced in the venous phase using a nonspecific contrast agent or gadobenate dimeglumine. However, when using gadoxetate disodium, the central scar and the spokes are hypointense due to pseudo washout (b). After 20 min, the majority of the lesion (except the scar) becomes hyperintense due to internal bile duct proliferation (c).