Abstract
Among benign liver tumors, hemangiomas and focal nodular hyperplasia (FNH) are by far the most commonly detected, being associated in 20 % of cases; due to specific imaging features such as the pattern of contrast enhancement and tumor morphology, the diagnosis of these benign tumors in most cases is confidently carried out with contrast-enhanced US, MRI, or CT with no need for percutaneous biopsy or surgical resection. Hepatic adenomas are rare entities that in many cases show specific imaging features related to the intracellular accumulation of fat or glycogen and to the presence of various degrees of hemorrhage, necrosis, and calcifications, better investigated with magnetic resonance and, in particular, with the chemical shift technique. Hepatic cysts are not considered liver tumors unless they must be differentiated from biliary cystadenoma and cystic metastases. Hepatic hemangiomas shows a typical pattern on T2w images and on contrast-enhanced study. Further information in the distinction of these lesions is provided by the hepatobiliary phase at MRI with hepatocyte-specific contrast agents: while FNH is inconstantly hyperintense to the liver, all the other tumors tend to be markedly hypointense, lacking the intracellular accumulation of the contrast agent.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Lewis RB, Lattin GE Jr, Makhlouf HR, Levy AD (2010) Tumors of the liver and intrahepatic bile ducts: radiologic-pathologic correlation. Magn Reson Imaging Clin N Am 18(3):587–609. doi:10.1016/j.mric.2010.08.010, xii
Semelka RC, Martin DR, Balci NC (2005) Focal lesions in normal liver. J Gastroenterol Hepatol 20(10):1478–1487. doi:10.1111/j.1440-1746.2005.03854.x
Bartolotta TV, Taibbi A, Midiri M, Lagalla R (2009) Focal liver lesions: contrast-enhanced ultrasound. Abdom Imaging 34(2):193–209. doi:10.1007/s00261-008-9378-6
Bonder A, Afdhal N (2012) Evaluation of liver lesions. Clin Liver Dis 16(2):271–283. doi:10.1016/j.cld.2012.03.001
Dietrich CF, Sharma M, Gibson RN, Schreiber-Dietrich D, Jenssen C (2013) Fortuitously discovered liver lesions. World J Gastroenterol 19(21):3173–3188. doi:10.3748/wjg.v19.i21.3173
Bartolozzi C, Cioni D, Donati F, Lencioni R (2001) Focal liver lesions: MR imaging-pathologic correlation. Eur Radiol 11(8):1374–1388
Heiken JP (2007) Distinguishing benign from malignant liver tumours. Cancer Imaging 7(Spec No A):S1–S14. doi:10.1102/1470-7330.2007.9084
Semelka RC (2005) Hepatic imaging. Radiol Clin North Am 43(5):xi. doi:10.1016/j.rcl.2005.07.006
Marrero JA, Ahn J, Reddy KR (2014) ACG Clinical Guideline: The Diagnosis and Management of Focal Liver Lesions, Am J Gastroenterol. 109(9):1328–1347. doi:10.1038/ajg.2014.213
Alobaidi M, Shirkhoda A (2004) Malignant cystic and necrotic liver lesions: a pattern approach to discrimination. Curr Probl Diagn Radiol 33(6):254–268. doi:10.1067/j.cpradiol.2004.08.002
Prasad SR, Wang H, Rosas H, Menias CO, Narra VR, Middleton WD et al (2005) Fat-containing lesions of the liver: radiologic-pathologic correlation. Radiographics 25(2):321–331. doi:10.1148/rg.252045083
Valls C, Iannacconne R, Alba E, Murakami T, Hori M, Passariello R et al (2006) Fat in the liver: diagnosis and characterization. Eur Radiol 16(10):2292–2308. doi:10.1007/s00330-006-0146-0
van den Bos IC, Hussain SM, de Man RA, Zondervan PE, Ijzermans JN, Preda A et al (2008) Magnetic resonance imaging of liver lesions: exceptions and atypical lesions. Curr Probl Diagn Radiol 37(3):95–103. doi:10.1067/j.cpradiol.2007.07.002
Marin D, Brancatelli G, Federle MP, Lagalla R, Catalano C, Passariello R et al (2008) Focal nodular hyperplasia: typical and atypical MRI findings with emphasis on the use of contrast media. Clin Radiol 63(5):577–585. doi:10.1016/j.crad.2007.06.011
Op de Beeck B, Luypaert R, Dujardin M, Osteaux M (1999) Benign liver lesions: differentiation by magnetic resonance. Eur J Radiol 32(1):52–60
Ronot M, Vilgrain V (2014) Imaging of benign hepatocellular lesions: current concepts and recent updates. Clin Res Hepatol Gastroenterol 38(6):681–8. doi:10.1016/j.clinre.2014.01.014
Campos JT, Sirlin CB, Choi JY (2012) Focal hepatic lesions in Gd-EOB-DTPA enhanced MRI: the atlas. Insights Imaging 3(5):451–474. doi:10.1007/s13244-012-0179-7
Goodwin MD, Dobson JE, Sirlin CB, Lim BG, Stella DL (2011) Diagnostic challenges and pitfalls in MR imaging with hepatocyte-specific contrast agents. Radiographics 31(6):1547–1568. doi:10.1148/rg.316115528
Flejou JF, Barge J, Menu Y, Degott C, Bismuth H, Potet F et al (1985) Liver adenomatosis. An entity distinct from liver adenoma? Gastroenterology 89(5):1132–1138
Cogley JR, Miller FH (2014) MR imaging of benign focal liver lesions. Radiol Clin North Am 52(4):657–682. doi:10.1016/j.rcl.2014.02.005
Martin DR, Danrad R, Hussain SM (2005) MR imaging of the liver. Radiol Clin North Am 43(5):861–886. doi:10.1016/j.rcl.2005.05.001, viii
Khosa F, Khan AN, Eisenberg RL (2011) Hypervascular liver lesions on MRI. Am J Roentgenol 197(2):W204–W220. doi:10.2214/ajr.10.5382
Hwang HS, Kim SH, Jeon TY, Choi D, Lee WJ, Lim HK (2009) Hypointense hepatic lesions depicted on gadobenate dimeglumine-enhanced three-hour delayed hepatobiliary-phase MR imaging: differentiation between benignancy and malignancy. Korean J Radiol 10(3):294–302. doi:10.3348/kjr.2009.10.3.294
Miller FH, Hammond N, Siddiqi AJ, Shroff S, Khatri G, Wang Y et al (2010) Utility of diffusion-weighted MRI in distinguishing benign and malignant hepatic lesions. J Magn Reson Imaging 32(1):138–147. doi:10.1002/jmri.22235
Sasaki M, Yamada K, Watanabe Y, Matsui M, Ida M, Fujiwara S et al (2008) Variability in absolute apparent diffusion coefficient values across different platforms may be substantial: a multivendor, multi-institutional comparison study. Radiology 249(2):624–630. doi:10.1148/radiol.2492071681
Brancatelli G, Federle MP, Ambrosini R, Lagalla R, Carriero A, Midiri M et al (2007) Cirrhosis: CT and MR imaging evaluation. Eur J Radiol 61(1):57–69. doi:10.1016/j.ejrad.2006.11.003
Lee JM, Choi BI (2011) Hepatocellular nodules in liver cirrhosis: MR evaluation. Abdom Imaging 36(3):282–289. doi:10.1007/s00261-011-9692-2
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing AG Switzerland
About this chapter
Cite this chapter
De Cobelli, F., Marra, P., Ironi, G., Esposito, A., Del Maschio, A. (2015). Systematics of Imaging Morphology. In: Aldrighetti, L., Cetta, F., Ferla, G. (eds) Benign Tumors of the Liver. Springer, Cham. https://doi.org/10.1007/978-3-319-12985-3_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-12985-3_6
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-12984-6
Online ISBN: 978-3-319-12985-3
eBook Packages: MedicineMedicine (R0)