Skip to main content

Hepatic Hemangioma, Focal Nodular Hyperplasia, and Hepatocellular Adenoma

  • Chapter
  • First Online:
Imaging of the Liver and Intra-hepatic Biliary Tract

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 580 Accesses

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

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

    Article  PubMed  Google Scholar 

  • Brannigan M, Burns PN, Wilson SR (2004) Blood flow patterns in focal liver lesions at microbubble-enhanced US. Radiographics 24(4):921–935

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  CAS  Google Scholar 

  • Cogley JR, Miller FH (2014) MR imaging of benign focal liver lesions. Radiol Clin North Am 52(4):657–682

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • EASL Clinical Practice Guidelines on the management of benign liver tumours (2016) J Hepatol 65(2):386–398

    Article  Google Scholar 

  • Gangahdar K, Santhosh D et al (2014) MRI Evaluation of masses in the noncirrhotic liver. Appl Radiol 2014:20–28

    Google Scholar 

  • Grazioli L et al (2013) MR imaging of hepatocellular adenomas and differential diagnosis dilemma. Int J Hepatol 374170, 20 p

    Google Scholar 

  • Hartleb M, Gutkowski K (2011) Nodular regenerative hyperplasia: evolving concepts on underdiagnosed cause of portal hypertension. World J Gastroenterol 17(11):1400–1409

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  CAS  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  CAS  Google Scholar 

  • 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

    Article  Google Scholar 

  • Maillette L et al (2010) Focal nodular hyperplasia and hepatic adenoma: epidemiology and pathology. Dig Surg 27:24–31

    Article  Google Scholar 

  • Margolskee E, Bao F et al (2016) Hepatocellular adenoma classification: a comparative evaluation of immunohistochemistry and targeted mutational analysis. Diagn Pathol 11:27

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  CAS  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  CAS  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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

    Article  PubMed  PubMed Central  Google Scholar 

  • 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

    Article  Google Scholar 

  • Ronot M, Vilgrain V (2014) Imaging of benign hepatocellular lesions: current concepts and recent updates. Clin Res Hepatol Gastroenterol 38(6):681–688

    Article  Google Scholar 

  • 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

    Article  CAS  Google Scholar 

  • 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

    Article  Google Scholar 

  • Vijay A, Elaffandi A, Khalaf H (2015) Hepatocellular adenoma: An update. World J Hepatol 7(25):2603–2609

    Article  Google Scholar 

  • 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

    Article  CAS  Google Scholar 

  • Wang W, Liu JY et al (2016) Hepatocellular adenoma: comparison between real-time contrast-enhanced ultrasound and dynamic computed tomography. Springerplus 5:951

    Article  Google Scholar 

  • 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

    Article  CAS  Google Scholar 

  • 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

    Chapter  Google Scholar 

  • 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

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

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

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-39021-1_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-39020-4

  • Online ISBN: 978-3-030-39021-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics