Hepatocellular adenoma MRI

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]Sabawoon Mirwais, M.B.B.S, M.D.[4]

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).

• The MR imgaing findings of hepatocellualar adenoma include:^{[1][2][3][4][5][6][7][8][9][10][11][12]}

• 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 calcifications.
• 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-attenuating signal.
• Dynamic post-gadolinium show intense arterial phase enhancement with iso-intensity on portal phase and delayed images.
• 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.
• With the injection of hepatocellular specific contrast agent, gadolinium benzyloxy propionic tetraacetate (Gd-BOTA), there is usually no significant uptake.

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