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Liver Adenomatosis: Classification of MR Imaging Features and Comparison with Pathologic Findings¹

¹ From the Departments of Radiology (M.L., L.A., E.B., J.M.T.) and Pathology (D.W., J.F.F.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France; and Departments of Pathology (A.H., V.P.), Hepatic Surgery (J.B.), and Radiology (V.V.), Hôpital Beaujon, Assistance Publique des Hôpitaux de Paris, Clichy, France. From the 2003 RSNA Annual Meeting. Received July 25, 2005; revision requested September 27; revision received October 27; accepted November 17; final version accepted February 1, 2006. Address correspondence to M.L. (e-mail: maite.lewin{at}sat.ap-hop-paris.fr).

Purpose: To retrospectively compare the clinical manifestation and magnetic resonance (MR) imaging features of liver adenomatosis with pathologic findings.

Materials and Methods: This study had institutional review board approval, and informed consent was waived. Twenty patients were classified on the basis of pathologic findings into three groups: those with a steatotic, those with a peliotic, and those with a mixed (steatotic and peliotic) form of liver adenomatosis. MR images were reviewed in consensus by two abdominal radiologists, and findings were compared with the pathologic classification. Statistical evaluation was performed with the Student t test.

Results: All patients were women (mean age, 39 years ± 10 [standard deviation]). Lesions of the steatotic form (n = 7) showed (a) a mean diameter of 6.3 cm ± 1.7, (b) slightly hyperintense signal on T2-weighted images, (c) hyper- or isointense signal on T1-weighted images with a signal dropout with fat suppression sequences, and (d) moderate enhancement at the arterial phase with no delayed enhancement. Lesions of the peliotic form (n = 7) showed (a) a somewhat larger size (8.3 cm ± 3.6), (b) markedly hyperintense signal on T2-weighted images, (c) iso- or hyperintensity on T1-weighted images with no signal dropout with fat suppression sequences, and (d) strong arterial enhancement and persistent enhancement at the portal and delayed phase. Lesions of the mixed form (n = 6) included a combination of imaging features of the steatotic and peliotic forms. Lesions, however, were significantly larger in the mixed form than in the steatotic form (10.3 cm ± 4, P < .05).

Conclusion: There are three patterns of MR imaging features of liver adenomatosis that are associated with three pathologic forms (steatotic, peliotic, and mixed).

© RSNA, 2006

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