Abstract
Benign focal liver lesions can originate from all kind of liver cells: hepatocytes, mesenchymal and cholangiocellular line. Their features at imaging may sometimes pose difficulties in differential diagnosis with malignant primary and secondary lesions. In particular, the use of MDCT and MRI with extracellular and hepatobiliary Contrast Agents may help in correct interpretation and definition of hepatocellular or mesenchymal and inflammatory nature, allowing to choose the best treatment option. The peculiarities of main benign liver lesions at US, CT and MRI are described, with special attention to differential diagnosis and diagnostic clue.
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References
Agarwal S, Fuentes Orrego JM et al (2014) Inflammatory hepatocellular adenomas can mimic focal nodular hyperplasia on gadoxetic acid-enhanced MRI. AJR Am J Roentgenol 203(4):W408–W414. https://doi.org/10.2214/AJR.13.12251
Brannigan M, Burns PN, Wilson SR (2004) Blood flow patterns in focal liver lesions at microbubble-enhanced US. Radiographics 24(4):921–935
Caseiro-Alves F, Brito J, EirasAraujo A, Belo-Soares P, Rodrigues H, Cipriano A, Sousa D, Mathieu D (2007) Liver haemangioma: common and uncommon findings and how to improve the differential diagnosis. Eur Radiol 17:1544–1554
Chan YL, Lee SF, Yu SC, Lai P, Ching AS (2002) Hepatic malignant tumour versus cavernous hemangioma: differentiation on multiple breath-hold turbo spin-echo MRI sequences with different T2 weighting and T2w-relaxation time measurements on a single slice multi-echo sequence. Clin Radiol 57(4):250–257
Cogley JR, Miller FH (2014) MR imaging of benign focal liver lesions. Radiol Clin North Am 52(4):657–682
Darai N, Shu R et al (2015) Atypical CT and MRI features of focal nodular hyperplasia of liver: a study with radiologic-pathologic correlation. Open J Radiol 5:131–141
Dhingra S, Fiel MI (2014) Update on the new classification of hepatic adenomas. Clinical, molecular, and pathologic characteristics. Arch Pathol Lab Med 138(8):1090–1097
Dioguardi Burgio M, Ronot M, Salvaggio G, Vilgrain V, Brancatelli G (2016) Imaging of hepatic focal nodular hyperplasia: pictorial review and diagnostic strategy. Semin Ultrasound CT MRI 37(6):511–524
Duran F, Ronot M, Kerbaol A, Van Beers B, Vilgrain V (2014) Hepatic hemangiomas: factors associated with T2 shine-through effect on diffusion-weighted MR sequences. Eur J Radiol 83(3):468–478
EASL Clinical Practice Guidelines on the management of benign liver tumours (2016) J Hepatol 65(2):386–398
Gangahdar K, Santhosh D et al (2014) MRI Evaluation of masses in the noncirrhotic liver. Appl Radiol 2014:20–28
Grazioli L et al (2013) MR imaging of hepatocellular adenomas and differential diagnosis dilemma. Int J Hepatol 374170, 20 p
Hartleb M, Gutkowski K (2011) Nodular regenerative hyperplasia: evolving concepts on underdiagnosed cause of portal hypertension. World J Gastroenterol 17(11):1400–1409
Hasan HY, Hinshaw L, Borman EJ, Gegios A, Leverson G, Winslow E (2014) Assessing normal growth of hepatic hemangiomas during long-term follow-up. JAMA Surg 149(12):12661271
Ishak KG, Anthony PP, Niederau C, Nakanuma Y. Mesenchymal tumours of the liver(2000) In: Hamilton SR, Aaltonen LA (eds) World Health Organization classification of tumours. Pathology and genetics of tumours of the digestive system. IARC, Lyon, pp 191–198
Jharap B, van Asseldonk DP et al (2015) Diagnosing nodular regenerative hyperplasia of the liver is thwarted by low Interobserver agreement. PLoS One 10(6):e0120299
Kaltenbach T, Engler P et al (2016) Prevalence of benign focal liver lesions: ultrasound investigation of 45,319 hospital patients. Abdom Radiol (NY) 41:25–32
Katabathina VS, Menias CO et al (2011) Genetics and imaging of hepatocellular adenomas. Radiographics 31(6):1529–1543. https://doi.org/10.1148/rg.316115527
Kim KW, Kim TK, Han JK, Kim AY, Lee HJ, Choi BI (2001) Hepatic hemangiomas with arterioportal shunt: findings at two-phase CT. Radiology 219(3):707–711
Kim KW, Kim TK, Han JK et al (2006 Oct) Hepatic hemangiomas with arterioportal shunt: sonographic appearances with CT and MRI correlation. AJR Am J Roentgenol 187(4):W406–W414
Klotz T, Montoriola P-F, Da Ines D, Petitcolin V, Joubert-Zakeyh J, Garcier J-M (2013) Hepatic hemangioma: common and uncommon imaging features. Diagn Interv Imaging 94:849–859 34
Lee NK, Kim S, Kim DU, Seo HII, Kim HS, Jo HJ et al (2014) Diffusion-weighted magnetic resonance imaging for non-neoplastic conditions in the hepatobiliary and pancreatic regions: pearls and potential pitfalls in imaging interpretation. Abdom Imaging 40(3):643–662
Maillette L et al (2010) Focal nodular hyperplasia and hepatic adenoma: epidemiology and pathology. Dig Surg 27:24–31
Margolskee E, Bao F et al (2016) Hepatocellular adenoma classification: a comparative evaluation of immunohistochemistry and targeted mutational analysis. Diagn Pathol 11:27
Marrero JA, Ahn J, Rajender Reddy K, ACG Clinical Guideline (2014) The diagnosis and management of focal liver lesions. Am J Gastroenterol 109(9):1328–1347
Miyamoto S, Oshita A, Daimaru Y, Sasaki M, Ohdan H, Nakamitsu A (2015) Hepatic sclerosed hemangioma: a case report and review of the literature. BMC Surg 15:45
Neri E, Bali MA, Ba-Ssalamah A et al (2016) ESGAR consensus statement on liver MR imaging and clinical use of liver-specific contrast agents. Eur Radiol 26:921–931
Parikh T, Drew SJ, Lee VS, Wong S, Hecht EM, Babb JS, Taouli B (2008) Focal liver lesions detection and characterization with diffusion-weighted MR imaging-comparison with standard breath-hold T2-weighted imaging. Radiology 246:812–822
Quaia E, Bartolotta TV, Midiri M et al (2006) Analysis of different contrast enhancement patterns after microbubble-based contrast agent injection in liver hemangiomas with atypical appearance on baseline scan. Abdom Imaging 31:59–64
Ridge CA, Shia J, Gerst SR, Do RK (2014 Apr) Sclerosed hemangioma of the liver: concordance of MRI features with histologic characteristics. J Magn Reson Imaging 39(4):812–818
Rodríguez de Lope C, Reig ME, Darnell A, Forner A (2012) Approach of the patient with a liver mass. Frontline Gastroenterol 3(4):252–262. https://doi.org/10.1136/flgastro-2012-100146
Roncalli M, Sciarra A, Di Tommaso L (2016) Benign hepatocellular nodules of healthy liver: focal nodular hyperplasia and hepatocellular adenoma. Clin Mol Hepatol 22(2):199–211
Ronot M, Vilgrain V (2014) Imaging of benign hepatocellular lesions: current concepts and recent updates. Clin Res Hepatol Gastroenterol 38(6):681–688
Tretiakova M, Hart J et al (2009) Distinction of hepatocellular adenoma from hepatocellular carcinoma with and without cirrhosis using E-cadherin and matrix metalloproteinase. Mod Pathol 22(8):1113–1120
Vanhooymissen I, Maarten GT et al (2019) Intrapatient comparison of the hepatobiliary phase of Gd-BOPTA and Gd-EOB-DTPA in the differentiation of hepatocellular adenoma from focal nodular hyperplasia. J Magn Reson Imaging 49(3):700–710
Vijay A, Elaffandi A, Khalaf H (2015) Hepatocellular adenoma: An update. World J Hepatol 7(25):2603–2609
Vilgrain V, Boulos L, Vullierme MP, Denys A, Terris B, Menu Y (2000) Imaging of atypical hemangiomas of the liver with pathologic correlation. Radiographics 20(2):379–397
Wang W, Liu JY et al (2016) Hepatocellular adenoma: comparison between real-time contrast-enhanced ultrasound and dynamic computed tomography. Springerplus 5:951
Yamashita Y, Ogata I, Urata J, Takahashi M (1997) Cavernous hemangioma of the liver: pathologic correlation with dynamic CT findings. Radiology 203(1):121–125
Youssef E, Baron RL, Elsayes KM (2015) Diagnostic approach of focal and diffuse hepatic diseases, Chapter 2. In: Elsayes KM (ed) Cross-sectional imaging of the abdomen and pelvis: a practical algorithmic approach. Springer, New York, pp 11–76
Yu JS, Kim MJ, Kim KW, Chang JC, Jo BJ, Kim TH et al (1998) Hepatic cavernous hemangioma: sonographic patterns and speed of contrast enhancement on multiphase dynamic MR imaging. AJR Am J Roentgenol 171(4):1021–1025
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Grazioli, L., Frittoli, B., Ambrosini, R., Bertuletti, M., Castagnoli, F. (2021). Hepatic Hemangioma, Focal Nodular Hyperplasia, and Hepatocellular Adenoma. In: Quaia, E. (eds) Imaging of the Liver and Intra-hepatic Biliary Tract. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-030-39021-1_1
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