Type:
Educational Exhibit
Keywords:
Not applicable, Molecular, genomics and proteomics, Image registration, Imaging sequences, Education, MR, Liver, Abdomen, Abdominal Viscera
Authors:
A. VERDU SEGUI, M. Martin Izquierdo, A. I. Sagredo Barra, S. Marquez Batalla, J. Sanz Repetto, K. MURADAS MUJIKA; Salamanca/ES
DOI:
10.26044/ecr2020/C-03480
Background
Hepatocellular adenomas (HCAs) are benigns liver tumors that are more frequently seen in young women with a history of use of oral contraceptives. There are other risk factors like glycogen storage disease, use of anabolic steroids, familiar liver adenomatosis or use of anabolic steroids. Hepatic adenomas are usually reported to be solitary (70-80% of cases).
Almost 50% of HCAs are diagnosed accidentally in asymptomatic patients. Large lesions can be symptomatic causing right upper abdominal quadrant fullness and discomfort and can complicate with breaking and bleeding .
Althought HCAs are usually detected by ultrasonography (US) and computed tomography (CT) and can be used to do a diagnostic approach, MR imaging is the imaging modality of choice for subtype characterization of hepatocellular adenomas. MR imaging allows more accurate detection and characterization of focal hepatic lesions.
At MRI, the imaging features of hepatic adenomas vary on the basis of the genetic and histophatological findings and associated complications. Recent studies concluded that some MR imaging patterns in patients with HCAs can be associated with three pathologic subtypes . These classification has high relevance to prevent and identify HCA´s complications like haemorrhage or malignant transformation in hepatocellular carcinoma . Large tumor (>5 cm) , exophytic lesions and inflammatory subtype are some risk factors for symptomatic bleeding. There are other risk factors for malignant transformation in hepatocellular carcinoma (5%-10% of cases) like large tumor , androgen use , metabolic syndrome and β-catenin-mutated hepatocellular adenoma .