Diagnosis and differential diagnosis between focal nodular hyperplasia with inflammatory hepatocellular adenoma on MRI
10.3760/cma.j.issn.1007-8118.2018.06.001
- VernacularTitle:肝脏局灶性结节性增生与炎症型肝细胞腺瘤的MRI表现和鉴别诊断
- Author:
Heqing WANG
1
;
Chun YANG
;
Ruofan SHENG
;
Shengxiang RAO
;
Mengsu ZENG
;
Jing HAN
;
Yuan JI
Author Information
1. 复旦大学附属中山医院放射诊断科
- Keywords:
Focal nodular hyperplasia;
Inflammatory hepatocellular adenoma;
Magnetic resonance imaging (MRI);
Comparative study
- From:
Chinese Journal of Hepatobiliary Surgery
2018;24(6):361-366
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the MRI features of focal nodular hyperplasia (FNH) and inflammatory hepatocellular adenoma (Ⅰ-HCA),with an aim to improve the diagnostic accuracy in the two lesions.Methods Patients who underwent dynamic-enhanced MRI with histopathologically confirmed FNHs (21 patients with 21 tumors) and Ⅰ-HCAs (10 patients with 12 tumors) were included in this retrospective study.The clinical and the imaging features,including the T2-and T1-weighted,diffusion weighted images,and the dynamic enhanced imagings were analyzed.Results No significant difference was observed in the clinical data between the 2 groups of patients,except in the serum levels of C-reactive protein.The serum C-reactive protein levels were significantly elevated in Ⅰ-HCA than in FNH.Significant differences between patients with FNHs and Ⅰ-HCAs were also found in the morphologic findings and the signal intensities (including shape,centre scar,necrosis,signal intensity of T2WI and DWI,and lesion signal intensity compared to those of the liver in the portal venous phase and delayed phase).The differences in lesion to liver signal in FNH were significantly lower than those in Ⅰ-HCA in the T2WI and the delayed phases.The area under the curve (AUC) for the 2 groups of patients were 0.843 and 0.743,respectively,with no significant difference between them.Conclusions The MRI appearances of atypical FNHs overlapped with Ⅰ-HCA.MRI features of isointensity on T2 Wl and DWI,and isointensity to the liver in the delayed phase were valuable to differentiate FNHs from Ⅰ-HCAs.Most Ⅰ-HCAs showed moderate and marked high signal intensity on T2WI and DWI.These features,when combined with an elevated serum C-reaction protein,necrosis in the lesion and hyperintensity in the delayed phase,were valuable in differentiating Ⅰ-HCAs from FNH.
