Difference between revisions of "Hepatocellular adenoma MRI"

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==Overview==
 
==Overview==
The [[Magnetic resonance imaging|MRI]] findings of [[hepatocellular adenoma]] include; from hyperintense to mildly hypointense relative to the [[liver]] [[Tissue (biology)|tissue]] on T1 weighted images. On T2 weighted images they are predominantly hyperintense relative to the [[liver]], whereas in the presence of [[necrosis]] and [[hemorrhage]] they can be [[heterogeneous]] with hyper or hypo [[Attenuation|attenuating]] signal. The central [[scar]] is on godalinium is not seen in [[hepatocellular adenoma]]. There is usually no significant uptake with injection of [[Hepatocyte|hepatocellular]] specific [[contrast]] agent, godalinium benzoyloxypropionictetraacetate (Gd-BOTA).
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The [[Magnetic resonance imaging|MRI]] findings of hepatocellular adenoma range from hyperintense to mildly hypointense relative to the [[liver]] [[Tissue (biology)|tissue]] on T1 weighted images. On T2 weighted images, the findings are predominantly hyperintense relative to the [[liver]], whereas in the presence of [[necrosis]] and [[hemorrhage]] they can be [[heterogeneous]] with hyper- or hypo-[[Attenuation|attenuating]] signal. The central [[scar]] on [[gadolinium]] is not seen in hepatocellular adenoma. There is usually no significant uptake with [[Injection (medicine)|injection]] of [[Hepatocyte|hepatocellular]] specific [[contrast|contrast agent]], gadolinium benzoyloxy propionic tetraacetate (Gd-BOTA).
  
 
==MRI==
 
==MRI==
* The [[magnetic resonance imaging|MR imgaing]] findings of [[hepatocellualar adenoma]] include;<ref>{{cite journal|doi=10.1594/ecr2013/C-2620}}</ref><ref name="DhingraFiel2014">{{cite journal|last1=Dhingra|first1=Sadhna|last2=Fiel|first2=M. Isabel|title=Update on the New Classification of Hepatic Adenomas: Clinical, Molecular, and Pathologic Characteristics|journal=Archives of Pathology & Laboratory Medicine|volume=138|issue=8|year=2014|pages=1090–1097|issn=0003-9985|doi=10.5858/arpa.2013-0183-RA}}</ref><ref name="NaultParadis2017">{{cite journal|last1=Nault|first1=Jean-Charles|last2=Paradis|first2=Valérie|last3=Cherqui|first3=Daniel|last4=Vilgrain|first4=Valérie|last5=Zucman-Rossi|first5=Jessica|title=Molecular classification of hepatocellular adenoma in clinical practice|journal=Journal of Hepatology|volume=67|issue=5|year=2017|pages=1074–1083|issn=01688278|doi=10.1016/j.jhep.2017.07.009}}</ref><ref>{{Cite journal
+
* The [[magnetic resonance imaging|MR imgaing]] findings of [[hepatocellualar adenoma]] include:<ref>{{cite journal|doi=10.1594/ecr2013/C-2620}}</ref><ref name="DhingraFiel2014">{{cite journal|last1=Dhingra|first1=Sadhna|last2=Fiel|first2=M. Isabel|title=Update on the New Classification of Hepatic Adenomas: Clinical, Molecular, and Pathologic Characteristics|journal=Archives of Pathology & Laboratory Medicine|volume=138|issue=8|year=2014|pages=1090–1097|issn=0003-9985|doi=10.5858/arpa.2013-0183-RA}}</ref><ref name="NaultParadis2017">{{cite journal|last1=Nault|first1=Jean-Charles|last2=Paradis|first2=Valérie|last3=Cherqui|first3=Daniel|last4=Vilgrain|first4=Valérie|last5=Zucman-Rossi|first5=Jessica|title=Molecular classification of hepatocellular adenoma in clinical practice|journal=Journal of Hepatology|volume=67|issue=5|year=2017|pages=1074–1083|issn=01688278|doi=10.1016/j.jhep.2017.07.009}}</ref><ref>{{Cite journal
 
  | author = [[Maarten G. Thomeer]], [[Mirelle Broker]], [[Joanne Verheij]], [[Michael Doukas]], [[Turkan Terkivatan]], [[Diederick Bijdevaate]], [[Robert A. De Man]], [[Adriaan Moelker]] & [[Jan N. IJzermans]]
 
  | author = [[Maarten G. Thomeer]], [[Mirelle Broker]], [[Joanne Verheij]], [[Michael Doukas]], [[Turkan Terkivatan]], [[Diederick Bijdevaate]], [[Robert A. De Man]], [[Adriaan Moelker]] & [[Jan N. IJzermans]]
 
  | title = Hepatocellular adenoma: when and how to treat? Update of current evidence
 
  | title = Hepatocellular adenoma: when and how to treat? Update of current evidence
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}}</ref><ref name="DharmanaSaravana-Bawan2017">{{cite journal|last1=Dharmana|first1=H.|last2=Saravana-Bawan|first2=S.|last3=Girgis|first3=S.|last4=Low|first4=G.|title=Hepatocellular adenoma: imaging review of the various molecular subtypes|journal=Clinical Radiology|volume=72|issue=4|year=2017|pages=276–285|issn=00099260|doi=10.1016/j.crad.2016.12.020}}</ref>
 
}}</ref><ref name="DharmanaSaravana-Bawan2017">{{cite journal|last1=Dharmana|first1=H.|last2=Saravana-Bawan|first2=S.|last3=Girgis|first3=S.|last4=Low|first4=G.|title=Hepatocellular adenoma: imaging review of the various molecular subtypes|journal=Clinical Radiology|volume=72|issue=4|year=2017|pages=276–285|issn=00099260|doi=10.1016/j.crad.2016.12.020}}</ref>
  
* From hyperintense to mildly hypointense relative to [[liver]] [[tissue]] on T1 weighted images. This [[heterogeneous]] appearance results from areas of high intensity due to [[fat]] and acute [[hemorrhage]] and low signal intensity area corresponding to [[necrosis]] or old [[hemorrhage]] or [[calcification|calcifications]].
+
* Signals range from hyperintense to mildly hypointense relative to [[liver]] [[tissue]] on T1 weighted images. This [[heterogeneous]] appearance results from areas of high intensity due to [[fat]] and acute [[hemorrhage]] and low signal intensity area corresponding to [[necrosis]] or old [[hemorrhage]] or [[calcification|calcifications]].
* The [[hepatocellular adenoma]] in T2 weighted images are predominantly hyperintense relative to [[liver]], although in the presence of [[necrosis]] and [[hemorrhage]] they can be [[heterogeneous]] with hyper and hypo [[attenuation|attenuating]] signal.
+
* The hepatocellular adenoma in T2 weighted images is predominantly hyperintense relative to [[liver]], although in the presence of [[necrosis]] and [[hemorrhage]] they can be [[heterogeneous]] with hyper- and hypo-[[attenuation|attenuating]] signal.
* Dynamic postgodalinium show intense [[artery|arterial]] phase enhancement with isointensity on portal phase and delayed images.
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* Dynamic post-[[gadolinium]] show intense [[artery|arterial]] phase enhancement with iso-intensity on [[portal]] phase and delayed images.
* [[Hepatocellular adenoma]] do not have a central [[scar]] so if a central [[scar]] enhances after godalinium is administered, the [[diagnosis]] of [[focal nodular hyperplasia]] is strongly favored.
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* Hepatocellular adenoma does not have a central [[scar]] so if a central [[scar]] enhances after gadolinium is administered, the [[diagnosis]] of [[focal nodular hyperplasia]] is strongly favored.
* A central [[scar]] has never been reported in [[hepatocellular adenoma|hepatocellular adenomas]].
+
* With the [[Injection (medicine)|injection]] of [[hepatocyte|hepatocellular]] specific [[contrast|contrast agent]], gadolinium benzyloxy propionic tetraacetate (Gd-BOTA), there is usually no significant uptake.
* With the injection of [[hepatocyte|hepatocellular]] specific [[contrast]] agent, godalinium benzyloxypropionictetraacetate (Gd-BOTA) there is usually no significant uptake.
+
 
 
==Images==
 
==Images==
 
[[File:Hepatic Adenoma MRI.jpg|300px|left|thumb|MRI showing multiple hepatocellular adenomas (yellow arrows). [https://radiopaedia.org/articles/hepatic-adenoma?lang=us Case courtesy of Dr Chris O'Donnell, Radiopaedia.org, rID: 26904]]]
 
[[File:Hepatic Adenoma MRI.jpg|300px|left|thumb|MRI showing multiple hepatocellular adenomas (yellow arrows). [https://radiopaedia.org/articles/hepatic-adenoma?lang=us Case courtesy of Dr Chris O'Donnell, Radiopaedia.org, rID: 26904]]]

Revision as of 17:44, 21 August 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Zahir Ali Shaikh, MD[3]

Overview

The MRI findings of hepatocellular adenoma range from hyperintense to mildly hypointense relative to the liver tissue on T1 weighted images. On T2 weighted images, the findings are predominantly hyperintense relative to the liver, whereas in the presence of necrosis and hemorrhage they can be heterogeneous with hyper- or hypo-attenuating signal. The central scar on gadolinium is not seen in hepatocellular adenoma. There is usually no significant uptake with injection of hepatocellular specific contrast agent, gadolinium benzoyloxy propionic tetraacetate (Gd-BOTA).

MRI

Images

MRI showing multiple hepatocellular adenomas (yellow arrows). Case courtesy of Dr Chris O'Donnell, Radiopaedia.org, rID: 26904


References

  1. . doi:10.1594/ecr2013/C-2620. Missing or empty |title= (help)
  2. Dhingra, Sadhna; Fiel, M. Isabel (2014). "Update on the New Classification of Hepatic Adenomas: Clinical, Molecular, and Pathologic Characteristics". Archives of Pathology & Laboratory Medicine. 138 (8): 1090–1097. doi:10.5858/arpa.2013-0183-RA. ISSN 0003-9985.
  3. Nault, Jean-Charles; Paradis, Valérie; Cherqui, Daniel; Vilgrain, Valérie; Zucman-Rossi, Jessica (2017). "Molecular classification of hepatocellular adenoma in clinical practice". Journal of Hepatology. 67 (5): 1074–1083. doi:10.1016/j.jhep.2017.07.009. ISSN 0168-8278.
  4. Maarten G. Thomeer, Mirelle Broker, Joanne Verheij, Michael Doukas, Turkan Terkivatan, Diederick Bijdevaate, Robert A. De Man, Adriaan Moelker & Jan N. IJzermans (2016). "Hepatocellular adenoma: when and how to treat? Update of current evidence". Therapeutic advances in gastroenterology. 9 (6): 898–912. doi:10.1177/1756283X16663882. PMID 27803743. Unknown parameter |month= ignored (help)
  5. L. Arrive, J. F. Flejou, V. Vilgrain, J. Belghiti, D. Najmark, M. Zins, Y. Menu, J. M. Tubiana & H. Nahum (1994). "Hepatic adenoma: MR findings in 51 pathologically proved lesions". Radiology. 193 (2): 507–512. doi:10.1148/radiology.193.2.7972769. PMID 7972769. Unknown parameter |month= ignored (help)
  6. Massimo Roncalli, Amedeo Sciarra & Luca Di Tommaso (2016). "Benign hepatocellular nodules of healthy liver: focal nodular hyperplasia and hepatocellular adenoma". Clinical and molecular hepatology. 22 (2): 199–211. doi:10.3350/cmh.2016.0101. PMID 27189732. Unknown parameter |month= ignored (help)
  7. Matthanja Bieze, Jacomina W. van den Esschert, C. Yung Nio, Joanne Verheij, Johannes B. Reitsma, Valeska Terpstra, Thomas M. van Gulik & Saffire S. K. S. Phoa (2012). "Diagnostic accuracy of MRI in differentiating hepatocellular adenoma from focal nodular hyperplasia: prospective study of the additional value of gadoxetate disodium". AJR. American journal of roentgenology. 199 (1): 26–34. doi:10.2214/AJR.11.7750. PMID 22733890. Unknown parameter |month= ignored (help)
  8. Andrei S. Purysko, Erick M. Remer, Christopher P. Coppa, Nancy A. Obuchowski, Erika Schneider & Joseph C. Veniero (2012). "Characteristics and distinguishing features of hepatocellular adenoma and focal nodular hyperplasia on gadoxetate disodium-enhanced MRI". AJR. American journal of roentgenology. 198 (1): 115–123. doi:10.2214/AJR.11.6836. PMID 22194486. Unknown parameter |month= ignored (help)
  9. Sheela Agarwal, Jorge M. Fuentes-Orrego, Thomas Arnason, Joseph Misdraji, Kartik S. Jhaveri, Mukesh Harisinghani & Peter F. Hahn (2014). "Inflammatory hepatocellular adenomas can mimic focal nodular hyperplasia on gadoxetic acid-enhanced MRI". AJR. American journal of roentgenology. 203 (4): W408–W414. doi:10.2214/AJR.13.12251. PMID 25055198. Unknown parameter |month= ignored (help)
  10. Maarten G. Thomeer, Francois E. Willemssen, Katharina K. Biermann, Haroun El Addouli, Rob A. de Man, Jan N. Ijzermans & Roy S. Dwarkasing (2014). "MRI features of inflammatory hepatocellular adenomas on hepatocyte phase imaging with liver-specific contrast agents". Journal of magnetic resonance imaging : JMRI. 39 (5): 1259–1264. doi:10.1002/jmri.24281. PMID 23897798. Unknown parameter |month= ignored (help)
  11. Heqing Wang, Chun Yang, Shengxiang Rao, Yuan Ji, Jing Han, Ruofan Sheng & Mengsu Zeng (2018). "MR imaging of hepatocellular adenomas on genotype-phenotype classification: A report from China". European journal of radiology. 100: 135–141. doi:10.1016/j.ejrad.2018.01.023. PMID 29496071. Unknown parameter |month= ignored (help)
  12. Dharmana, H.; Saravana-Bawan, S.; Girgis, S.; Low, G. (2017). "Hepatocellular adenoma: imaging review of the various molecular subtypes". Clinical Radiology. 72 (4): 276–285. doi:10.1016/j.crad.2016.12.020. ISSN 0009-9260.

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