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Hepatocellular Adenoma: Multiphasic CT and Histopathologic Findings in 25 Patients¹

¹ From the Department of Radiology, Yamanashi Medical University, Nakakoma, Japan (T.I.); the Departments of Radiology (M.P.F.) and Pathology (M.N.), University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA 15213; and the Department of Radiology, Spedali Civili Brescia, Italy (L.G.). Received March 22, 1999; revision requested May 3; revision received June 22; accepted July 20. Address reprint requests to M.P.F. (e-mail: federlemp@radserv.arad.upmc.edu).

PURPOSE: To evaluate multiphasic computed tomographic (CT) findings of hepatic adenomas and to correlate these findings with those of histopathologic analysis.

MATERIALS AND METHODS: Multiphasic helical CT was performed in 25 patients with 44 hepatic adenomas. Nonenhanced scans were obtained in all cases, along with hepatic arterial–dominant phase (HAP) and portal venous–dominant phase (PVP) images at 25–28 and 60–70 seconds after intravenous contrast material injection at 3–5 mL/sec. Twelve patients with 24 adenomas also underwent delayed-phase (5–10-minute) CT. Two independent readers retrospectively reviewed each case for the number of detectable lesions in each CT phase, morphologic features of tumors, and degrees of enhancement.

RESULTS: Thirteen patients had solitary adenomas; 12 patients had two or three adenomas. Both observers agreed on the numbers of lesions detected in all cases and in all phases of enhancement. The detection rate for all 44 adenomas per type of examination was as follows: nonenhanced, 86% (38 of 44); HAP, 100% (44 of 44); PVP, 82% (36 of 44), and delayed, 88% (21 of 24). Tumor margins were well defined in 38 adenomas (86%), and the surface was smooth in 42 adenomas (95%). The right hepatic lobe was the only site of adenoma or was a site along with the left lobe in 29 cases (66%). Tumor fat and calcifications were uncommon (three cases [7%] and two cases [5%], respectively). Other than areas of fat, hemorrhage, or necrosis, the adenomas enhanced nearly homogeneously, especially on PVP and delayed-phase scans. Five patients had coexistent hepatic masses, which were focal nodular hyperplasia (n = 3) or hepatocellular carcinoma (n = 2).

CONCLUSION: Hepatic adenomas often have characteristic features at multiphasic CT that may allow their distinction from other hepatic masses.

Index terms: Liver neoplasms, CT, 761.12113, 761.12114, 761.12115, 761.12119 • Liver neoplasms, diagnosis, 761.3192, 761.3198, 761.323, 761.35

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