Characterization of hepatic adenoma and focal nodular hyperplasia with gadoxetic acid

Authors

  • Kiyarash Mohajer MD,

    1. Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
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  • Alex Frydrychowicz MD,

    1. Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
    2. Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany
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  • Jessica B. Robbins MD,

    1. Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
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  • Agnes G. Loeffler MD, PhD,

    1. Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison, Wisconsin, USA
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  • Thomas D. Reed MD,

    1. Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
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  • Scott B. Reeder MD, PhD

    Corresponding author
    1. Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
    2. Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, USA
    3. Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
    4. Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
    • Department of Radiology, E1/374 CSC, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792-3252
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Abstract

Purpose:

To characterize imaging features of histologically proven hepatic adenoma (HA) as well as histologically and/or radiologically proven focal nodular hyperplasia (FNH) using delayed hepatobiliary MR imaging with 0.05 mmol/kg gadoxetic acid.

Materials and Methods:

Five patients with six HAs with histological correlation were retrospectively identified on liver MRI studies performed with gadoxetic acid, and T1-weighted imaging acquired during the delayed hepatobiliary phase. Additionally, 23 patients with 34 radiologically diagnosed FNH lesions (interpreted without consideration of delayed imaging) were identified, two of which also had histological confirmation. Signal intensity ratios relative to adjacent liver were measured on selected imaging sequences.

Results:

All six hepatic adenomas (100%), which had histological confirmation, demonstrated hypointensity relative to adjacent liver on delayed imaging. Furthermore, all of the FNH (including 34 radiologically proven, 2 of which were also histologically proven) were either hyperintense (23/34, 68%) or isointense (11/34, 32%) relative to the adjacent liver on delayed imaging. None of the FNHs were hypointense relative to liver.

Conclusion:

Distinct imaging characteristics of HA versus FNH on delayed gadoxetic acid-enhanced MRI, with adenomas being hypointense and FNH being iso- or hyperintense on delayed imaging may improve specificity for characterization, and aid in the differentiation of these two lesions. J. Magn. Reson. Imaging 2012;36:686–696. © 2012 Wiley Periodicals, Inc.

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