MRI features of inflammatory hepatocellular adenomas on hepatocyte phase imaging with liver-specific contrast agents

J Magn Reson Imaging. 2014 May;39(5):1259-64. doi: 10.1002/jmri.24281. Epub 2013 Jul 29.

Abstract

Purpose: To evaluate the presentation of inflammatory hepatocellular adenomas (HCAs) on hepatocyte phase MRI.

Materials and methods: We retrospectively reviewed the MRI features of histologically proven HCAs on hepatocyte phase imaging. Twenty-one lesions (17 with inflammatory subtype) were scanned with gadobenate dimeglumine. Signal intensities of the lesions were assessed in the hepatocyte phase and on the T1-weighted sequences before contrast.

Results: After gadobenate dimeglumine injection, 71% (12/17) of the inflammatory HCAs showed areas of iso- or hyperintensity to the surrounding liver in the hepatocyte phase. In 82% (10/12) of the iso- or hyperintense lesions, this was found over more than 75% of the lesion surface. None of the noninflammatory HCAs showed areas of iso- or hyperintensity to the surrounding liver in the hepatocyte phase. From these 12, 7 were hyperintense on T1-weighting before contrast due to liver steatosis, 2 due to intrinsic hyperintensity (on the in-phase sequence), and 3 were isointense.

Conclusion: In contrast to noninflammatory HCAs, inflammatory HCAs can show areas of iso- to hyperintensity to the surrounding liver in the hepatocyte phase; therefore, other typical imaging features should also be used to distinguish between HCAs and FNHs.

Keywords: MRI; gadobenate dimeglumine; gadoxetate disodium; hepatocellular adenoma.

MeSH terms

  • Adenoma, Liver Cell / pathology*
  • Adult
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Focal Nodular Hyperplasia / pathology*
  • Hepatitis / complications
  • Hepatitis / pathology*
  • Hepatocytes / pathology*
  • Humans
  • Image Enhancement / methods
  • Liver Neoplasms / pathology*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Meglumine / analogs & derivatives*
  • Middle Aged
  • Organometallic Compounds*
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • Organometallic Compounds
  • gadobenic acid
  • Meglumine