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Figure 4. MRI appearance of SH-HCC developed in a 67-year-old patient with metabolic dysfunction-associated steatohepatitis. Unenhanced fat-suppressed T1 image shows a 30 mm nodule in the left liver lobe (A). Gadolinium-enhanced fat-suppressed T1 images obtained during the hepatic arterial phase (B) and late venous phase (C) show that the lesion has a non-rim arterial phase hyperenhancement (B - arrow), washout, and enhancing capsule (C - arrow). The nodule shows a diffuse drop of the signal intensity on T1 out-of-phase image (E - asterisk) compared to the T1 in-phase image (D), consistent with a fat in mass appearance. MRI: Magnetic resonance imaging; SH-HCC: steatohepatitic hepatocellular carcinoma.