Hepatocellular adenomas( HCA) are rare benign tumors of the liver,and according to the differences in molecular genetics and pathology,HCA is categorized as inflammatory hepatocellular adenoma( IHCA),HCA with hepatocyte nuclear factor 1-alpha mutation( H-HCA),HCA with β-catenin mutation( β-HCA),and an undefined type. The incidence of these four types is 40%-50%,30%-40%,10%-15%,and 10%,respectively. In these four types of HCA,β-HCA has high risk of bleeding and malignant transformation,while H-HCA is not likely to show malignant transformation. Therefore,the accurate diagnosis of these types of HCA is very important. This article introduces the radiological features of these types of HCA on conventional MRI and hepatocyte-targeted contrast-enhanced scan and compares these findings with other types of liver solid tumors such as focal nodular hyperplasia,nodular regenerative hyperplasia,liver cancer in non-cirrhotic patients,and fibrolamellar carcinoma of the liver. It is pointed out that MRI and hepatocyte-targeted contrast agents play an important role in the diagnosis and differentiation of HCA.
[1]WANG JH,ZHAO ZQ,LUO DL,et al.Multislice CT diagnosis of rare liver tumors[J].Diagn Imag Interv Radiol,2014,23(3):220-223.(in Chinese)王建华,赵志清,罗帝林,等.肝脏少见肿瘤多层螺旋CT分析[J].影像诊断与介入放射学,2014,23(3):220-223.
|
[2]BLANC JF,FRULIO N,CHICHE L,et al.Hepatocellular adenoma management:call for shared guidelines and multidisciplinary approach[J].Clin Res Hepatol Gastroenterol,2015,39(2):180-187.
|
[3]KHANNA M,RAMANATHAN S,FASIH N,et al.Current updates on the molecular genetics and magnetic resonance imaging of focal nodular hyperplasia and hepatocellular adenoma[J].Insights Into Imaging,2015,6(3):347-362.
|
[4]BALABAUD C,AL-RABIH WR,CHEN PJ,et al.Focal nodular hyperplasia and hepatocellular adenoma around the world viewed through the scope of the immunopathological classification[J].Int J Hepatol,2013,2013:268625.
|
[5]CAPPELL MS.Hepatic disorders severely affected by pregnancy:medical and obstetric management[J].Med Clin North Am,2008,92(4):739-760.
|
[6]NAULT JC,BIOULAC-SAGE P,ZUCMAN-ROSSI J.Hepatocellular benign tumors-form molecular classificationto personalized clinical care[J].Gastroenterology,2013,144(5):888-902.
|
[7]BUNCHORNTAVAKUL C,BAHIRWANI R,DRAZEK D,et al.Clinical features and natural history of hepatocellular adenonas:the impact of obesity[J].Aliment Pharmacol Ther,2011,34(6):664-674.
|
[8]BIOULAC-SAGE P,TAOUJI S,POSSENTI L,et al.Hepatocellular adenoma subtypes:the impact of overweight and obesity[J].Liver Int,2012,32(8):1217-1221.
|
[9]van AALTEN SM,de MAN RA,IJZERMANS JN,et al.Systematic review of haemorrhage and rupture of hepatocellular adenomas[J].Br J Surg,2012,99(7):911-916.
|
[10]FARGES O,FERREIRA N,DOKMAK S,et al.Changing trends in malignant transformation of hepatocellular adenoma[J].Gut,2011,60(1):85-89.
|
[11]BIOULAC-SAGE P,SEMPOUX C,POSSENTI L,et al.Pathological diagnosis of hepatocellular cellular adenoma according to the clinical context[J].Int J Hepatol,2013,2013:253261-253261.
|
[12]ZHU XL,LIN Q.Status and advances in imaging diagnosis of hepatic adenoma[J].Int J Radiat Med,2011,35(2):124-127.(in Chinese)朱晓琳,林强.肝腺瘤的影像诊断现状及进展[J].国际放射医学核医学杂志,2011,35(2):124-127.
|
[13]SINGHI AD,JAIN D,KAKAR S,et al.Reticulin loss in benign fatty liver:an important diagnostic pitfall when considering a diagnosis of hepatocellular carcinoma[J].Am J Pathol,2012,36(5):710-715.
|
[14]GRAZIOLI L,OLIVETTI L,MAZZA G,et al.MR imaging of hepatocellular adenomas and differential diagnosis dilemma[J].Int J Hepatol,2013,2013:374170.
|
[15]FURLAN A,BORHANI AA,HELLER MT,et al.Non-focal liver signal abnormalities on hepatobiliary phase of gadoxetate disodium-enhanced MR imaging:a review and differential diagnosis[J].Abdom Radiol(NY),2016,41(7):1399-1410.
|
[16]FRANCISCO FA,de ARAU'JO AL,OLIVEIRA NETO JA,et al.Hepatobiliary contrast agents:differential diagnosis of focal hepatic lesions,pitfalls and other indications[J].Radiol Bras,2014,47(5):301-309.
|
[17]van AALTEN SM,THOMEER MG,TERKIVATAN T,et al.Hepatocellular adenomas:correlation of MR imaging findings with pathologic subtype classification[J].Radiology,2011,261(1):172-181.
|
[18]RONOT M,VILGRAIN V.Imaging of benign hepatocellular lesions:current concepts and recent updates[J].Clin Res Hepatol Gastroenterol,2014,38(6):681-688.
|
[19]AGARWAL S,FUENTES-ORREGO JM,ARNASON T,et al.Inflammatory hepatocellular adenomas can mimic focal nodular hyperplasia on gadoxetic acid-enhanced MRI[J].AJR Am J Roentgenol,2014,203(4):408-414.
|
[20]THOMEER MG,WILLEMSSEN FE,KATHARINA K,et al.MRI features of inflammatory hepatocellular adenomas on hepatocyte phase imaging with liver-specific contrast agents[J].J Magn Reson Imaging,2014,39(5):1259-1264.
|
[21]PAULETTE B,LAUMONIER H,COUCHY G,et al.Hepatocellular adenoma management and phenotypic classification:the bordeaux experience[J].Hepatology,2009,50(2):481-489..
|
[22]SHANBHOGUE A,SHAH SN,ZAHEERA,et al.Hepatocellular adenomas:current update on genetics,taxonomy,and management[J].J Comput Assist Tomogr,2011,35(2):159-166.
|
[23]SHII M,KAZAOKA J,FUKUSHIMA J,et al.A case of-catenin-positive hepatocellular adenoma with MR imaging sign of diffuse intratumoral fat deposition[J].Abdom Imaging,2015,40(6):1-5.
|
[24]NGUYEN TB,RONCALLI M,di TOMMASO L,et al.Combined use of heat-shock protein 70 and glutamine synthetase is useful in the distinction of typical hepatocellular adenoma from atypical hepatocellular neoplasms and well-differentiated hepatocellular carcinoma[J].Mod Pathol,2016,29(3):283-292.
|
[25]LI T,QIN LX,LIN GL,et al.Spontaneous rupture and bleeding of hepatic focal nodular hyperplasia:a case report[J].Chin J Gen Surg,2007,22(9):713-714.(in Chinese)李涛,钦伦秀,林国领,等.肝脏局灶性结节增生自发破裂出血一例[J].中华普通外科杂志,2007,22(9):713-714.
|
[26]HASHIMOTO K,TATSUMI N,SHIMIZU J,et al.Resected focal nodular hyperplasia that was difficult to differentiate from hepatocellular carcinoma-a case report[J].Gan To Kagaku Ryoho,2015,42(12):1869-1871.
|
[27]BIOULAC-SAGE P,REBOUISSOU S,THOMAS C,et al.Hepatocellular adenoma subtype classification using molecular markers and immunohistochemistry[J].Hepatology,2007,46(3):740-748.
|
[28]MORANA G,GRAZIOLI L,KIRCHIN MA,et al.Solid hypervascular liver lesions:accurate identification of true benign lesions on enhanced dynamic and hepatobiliary phase magnetic resonance imaging after gadobenate dimeglumine administration[J].Invest Radiol,2011,46(4):225-239.
|
[29] CHALLAGULLA K.Radiologic and pathological presentation of fibrolamellar hepatic carcinoma of liver[D].Jilin:Jilin University,2015.(in Chinese)CHALLAGULLA K.纤维板层型肝癌的影像学和病理表现[D].吉林:吉林大学,2015.
|
[30]RITA G,LUIGI G,EMANUELA O,et al.Which is the best MRI marker of malignancy for atypical cirrhotic nodules:hypointensity in hepatobiliary phase alone or combined with other features?Classification after Gd-EOB-DTPA administration[J].J Magn Reson Imaging,2012,36(3):648-657.
|
[31]TSUDA N,MATSUI O.Cirrhotic rat liver:reference to transporter activity and morphologic changes in bile canaliculi——gadoxetic acid-enhanced MR imaging[J].Radiology,2010,256(3):767-773.
|
[32]CARAIANI CN,DAN M,FENESAN DI,et al.Description of focal liver lesions with Gd-EOB-DTPA enhanced MRI[J].Clujul Medical,2015,88(4):438-448.
|
[33]CAMPOS JT,SIRLIN CB,CHOI JY.Focal hepatic lesions in GdGD-EOB-DTPA enhanced MRI:the atlas[J].Insights Imaging,2012,3(5):451-474.
|
[34]ALBIIN N.MRI of focal liver lesions[J].Curr Med Imaging Rev,2012,8(2):107-116.
|
[35]EL-BADRAWY A,ASHMALLAH GA,TAWFIK AM,et al.Diffusion-Weighted MR Imaging of the benign hepatic focal lesions[J].O J Rad,2014,4(1):136-143.
|