Review Article

MR Imaging of Hepatocellular Adenomas and Differential Diagnosis Dilemma

Figure 5

β-catenin-mutated adenoma. (a) In S VI heterogeneous well delineated hyperintense lesion (arrows). (b-c) T1w in- and out-phased images. The mass is slightly hypointense relative to hepatic parenchyma with focal signal drop due to intralesional fatty infiltration (arrowhead). (d–g) DWI sequences. The lesion increases signal intensity from 50 (d) to 400 (e) and to 800 (f) b values. In ADC map (g) the nodule shows heterogeneous signal. (h–l) In dynamic evaluation after Gd-EOB-DTPA administration the mass shows intense heterogeneous enhancement in arterial phase (i) without evident wash out in portal (j) and (k) equilibrium phases. (l-m) In hepatobiliary phases after 10′ (l) and 20′ (m), the lesions are heterogeneous hypointense relative to the adjacent liver parenchyma. (n-o) Gross specimen confirms capsulated heterogeneous mass with fatty component (arrowheads).
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