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Comparison of MRI features for the differentiation of hepatic angiomyolipoma from fat-containing hepatocellular carcinoma

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Abstract

Objective

The purpose of this study was to evaluate MRI features for the differentiation of hepatic angiomyolipoma (HAML) from fat-containing hepatocellular carcinoma.

Methods

We retrospectively reviewed the MRI findings of 20 patients with 22 hepatic angiomyolipomas and 25 patients with fat-containing hepatocellular carcinomas before surgery. The MRI features and apparent diffusion coefficient (ADC) for the two types of tumors were compared and analyzed.

Results

Fat was not detected in nine (40.9%) of the angiomyolipomas. An enhancement pattern of the washout area was seen in eight (36.4%) of the angiomyolipomas and 21 of the hepatocellular carcinomas (84%) (p = 0.001). The sensitivity, specificity, and accuracy of the enhancement pattern for HAML were 63.6% (14/22), 84% (21/25), and 74.5% (35/47), respectively. An early draining vein was seen in 16 (72.7%) angiomyolipomas and two hepatocellular carcinomas (8%) (p < 0.001). The sensitivity, specificity, and accuracy of an early draining vein for detecting HAML was 72.7% (16/22), 92% (23/25), and 83.0% (39/47), respectively. Tumor vessels were noted in 18 (81.8%) angiomyolipomas and six hepatocellular carcinomas (24%) (p < 0.001). The sensitivity, specificity, and accuracy of tumor vessels for HAML were 81.8% (18/22), 76% (19/25), and 78.7% (37/47), respectively. Pseudocapsules were absent in 21 (95.5%) angiomyolipomas as compared with 3 (12%) hepatocellular carcinomas (p < 0.001). The sensitivity, specificity, and accuracy of pseudocapsules for HAML were 95.5% (21/22), 88% (22/25), and 91.5% (43/47), respectively. The ADC of the angiomyolipomas (1.92 ± 0.29 × 10−3 mm2/s) was significantly higher than that for hepatocellular carcinomas (1.33 ± 0.25 × 10−3 mm2/s) (p < 0.001).

Conclusion

The presence of an early draining vein and tumor vessels, the absence of pseudocapsules and a higher ADC in the hypervascular hepatic tumor on the MRI were helpful for the differentiation of hepatic angiomyolipoma from fat-containing hepatocellular carcinoma.

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Authors and Affiliations

  1. Department of Radiology, Changshu Second People’s Hospital, Changshu, Jiangsu, 215500, China

    Sheng-yu Wang & Xin-ping Kuai

  2. Department of Radiology, Changzheng Hospital, The Second Military Medical University, Shanghai, 200003, China

    Xiao-xi Meng

  3. Department of Radiology, Shanghai Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, 200438, China

    Ning-yang Jia

  4. Department of Pathology, Shanghai Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, 200438, China

    Hui Dong

Authors
  1. Sheng-yu Wang
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  2. Xin-ping Kuai
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  3. Xiao-xi Meng
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  4. Ning-yang Jia
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  5. Hui Dong
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Corresponding author

Correspondence to Ning-yang Jia.

Additional information

Sheng-yu Wang, Xin-ping Kuai and Xiao-xi Meng contributed equally to this work.

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Wang, Sy., Kuai, Xp., Meng, Xx. et al. Comparison of MRI features for the differentiation of hepatic angiomyolipoma from fat-containing hepatocellular carcinoma. Abdom Imaging 39, 323–333 (2014). https://doi.org/10.1007/s00261-013-0070-0

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