Skip to main content
Erschienen in: Abdominal Radiology 3/2013

01.06.2013

Hepatic angiomyolipoma: CT and MR imaging findings with clinical–pathologic comparison

verfasst von: Pei-qiang Cai, Yao-pan Wu, Chuan-miao Xie, Wei-dong Zhang, Rui Han, Pei-hong Wu

Erschienen in: Abdominal Radiology | Ausgabe 3/2013

Einloggen, um Zugang zu erhalten

Abstract

Objective

The objective of this study is to evaluate the clinical, pathologic, and computed tomography (CT) and/or magnetic resonance imaging (MRI) findings of hepatic angiomyolipoma (HAML) and to improve the diagnostic efficacy of the tumor.

Materials and methods

Clinical, pathologic, and imaging findings were retrospectively evaluated in 18 patients with HAML. Two patients underwent both CT and MRI, ten underwent CT alone, and six underwent MRI alone. Unenhanced and contrast-enhanced examinations were performed in all patients. Imaging characteristics, such as the lesion location, lesion diameter, presence of early draining veins, attenuation/signal intensity of the lesions on imaging, and enhancement pattern were reviewed.

Results

There were 3 male and 15 female patients. HAML was seen as a well-defined, solitary mass on imaging with medium size (mean diameter, 5.9 cm). Fat was detected in ten patients. Calcification was noted in two patients and cystic degeneration was seen in one patient. Hepatic cirrhosis and capsule were not detected in all patients. The mean attenuation values exceeded 120 hounsfield units (HU) in 11 patients (91.7%). Peripherally decreasing enhancement rim as well as early draining vein was seen in 15 patients (83.3%). The early draining veins were all hepatic veins. Tumor vessels were noted in all patients.

Conclusion

The presence of early draining vein, peripheral decreasing enhancement rim, and the absence of tumor capsule in the hypervascular hepatic tumor on CT and/or MRI together with normal alpha fetal protein may be helpful for the diagnosis of HAML in non-cirrhotic liver.
Literatur
1.
Zurück zum Zitat Zhong DR, Ji XL (2000) Hepatic angiomyolipoma-misdiagnosis as hepatocellular carcinoma: a report of 14 cases. World J Gastroenterol 6(4):608–612PubMed Zhong DR, Ji XL (2000) Hepatic angiomyolipoma-misdiagnosis as hepatocellular carcinoma: a report of 14 cases. World J Gastroenterol 6(4):608–612PubMed
2.
Zurück zum Zitat Kojima M, Nakamura S, Ohno Y, et al. (2004) Hepatic angiomyolipoma resembling an inflammatory pseudotumor of the liver. A case report. Pathol Res Pract 200(10):713–716PubMedCrossRef Kojima M, Nakamura S, Ohno Y, et al. (2004) Hepatic angiomyolipoma resembling an inflammatory pseudotumor of the liver. A case report. Pathol Res Pract 200(10):713–716PubMedCrossRef
3.
Zurück zum Zitat Ren N, Qin LX, Tang ZY, Wu ZQ, Fan J (2003) Diagnosis and treatment of hepatic angiomyolipoma in 26 cases. World J Gastroenterol 9(8):1856–1858PubMed Ren N, Qin LX, Tang ZY, Wu ZQ, Fan J (2003) Diagnosis and treatment of hepatic angiomyolipoma in 26 cases. World J Gastroenterol 9(8):1856–1858PubMed
4.
Zurück zum Zitat Tsui WM, Colombari R, Portmann BC, et al. (1999) Hepatic angiomyolipoma: a clinicopathologic study of 30 cases and delineation of unusual morphologic variants. Am J Surg Pathol 23(1):34–48PubMedCrossRef Tsui WM, Colombari R, Portmann BC, et al. (1999) Hepatic angiomyolipoma: a clinicopathologic study of 30 cases and delineation of unusual morphologic variants. Am J Surg Pathol 23(1):34–48PubMedCrossRef
5.
Zurück zum Zitat Yang CY, Ho MC, Jeng YM, et al. (2007) Management of hepatic angiomyolipoma. J Gastrointest Surg 11(4):452–457PubMedCrossRef Yang CY, Ho MC, Jeng YM, et al. (2007) Management of hepatic angiomyolipoma. J Gastrointest Surg 11(4):452–457PubMedCrossRef
6.
Zurück zum Zitat Li T, Wang L, Yu HH, et al. (2008) Hepatic angiomyolipoma: a retrospective study of 25 cases. Surg Today 38(6):529–535PubMedCrossRef Li T, Wang L, Yu HH, et al. (2008) Hepatic angiomyolipoma: a retrospective study of 25 cases. Surg Today 38(6):529–535PubMedCrossRef
7.
Zurück zum Zitat Ding GH, Liu Y, Wu MC, et al. (2011) Diagnosis and treatment of hepatic angiomyolipoma. J Surg Oncol 103(8):807–812PubMedCrossRef Ding GH, Liu Y, Wu MC, et al. (2011) Diagnosis and treatment of hepatic angiomyolipoma. J Surg Oncol 103(8):807–812PubMedCrossRef
8.
Zurück zum Zitat Chang Z, Zhang JM, Ying JQ, Ge YP (2011) Characteristics and treatment strategy of hepatic angiomyolipoma: a series of 94 patients collected from four institutions. J Gastrointestin Liver Dis 20(1):65–69PubMed Chang Z, Zhang JM, Ying JQ, Ge YP (2011) Characteristics and treatment strategy of hepatic angiomyolipoma: a series of 94 patients collected from four institutions. J Gastrointestin Liver Dis 20(1):65–69PubMed
9.
Zurück zum Zitat Ahmadi T, Itai Y, Takahashi M, et al. (1998) Angiomyolipoma of the liver: significance of CT and MR dynamic study. Abdom Imaging 23(5):520–526PubMedCrossRef Ahmadi T, Itai Y, Takahashi M, et al. (1998) Angiomyolipoma of the liver: significance of CT and MR dynamic study. Abdom Imaging 23(5):520–526PubMedCrossRef
10.
Zurück zum Zitat Hogemann D, Flemming P, Kreipe H, Galanski M (2001) Correlation of MRI and CT findings with histopathology in hepatic angiomyolipoma. Eur Radiol 11(8):1389–1395PubMedCrossRef Hogemann D, Flemming P, Kreipe H, Galanski M (2001) Correlation of MRI and CT findings with histopathology in hepatic angiomyolipoma. Eur Radiol 11(8):1389–1395PubMedCrossRef
11.
Zurück zum Zitat Takayama Y, Moriura S, Nagata J, et al. (2002) Hepatic angiomyolipoma: radiologic and histopathologic correlation. Abdom Imaging 27(2):180–183PubMedCrossRef Takayama Y, Moriura S, Nagata J, et al. (2002) Hepatic angiomyolipoma: radiologic and histopathologic correlation. Abdom Imaging 27(2):180–183PubMedCrossRef
12.
Zurück zum Zitat Jeon TY, Kim SH, Lim HK, Lee WJ (2010) Assessment of triple-phase CT findings for the differentiation of fat-deficient hepatic angiomyolipoma from hepatocellular carcinoma in non-cirrhotic liver. Eur J Radiol 73(3):601–606PubMedCrossRef Jeon TY, Kim SH, Lim HK, Lee WJ (2010) Assessment of triple-phase CT findings for the differentiation of fat-deficient hepatic angiomyolipoma from hepatocellular carcinoma in non-cirrhotic liver. Eur J Radiol 73(3):601–606PubMedCrossRef
13.
Zurück zum Zitat Xiao W, Zhou M, Lou H, Wang Z, Zhang M (2010) Hemodynamic characterization of hepatic angiomyolipoma with least amount of fat evaluated by contrast-enhanced magnetic resonance angiography. Abdom Imaging 35(2):203–207PubMedCrossRef Xiao W, Zhou M, Lou H, Wang Z, Zhang M (2010) Hemodynamic characterization of hepatic angiomyolipoma with least amount of fat evaluated by contrast-enhanced magnetic resonance angiography. Abdom Imaging 35(2):203–207PubMedCrossRef
14.
Zurück zum Zitat Kim SH, Lim HK, Lee WJ, Choi D, Park CK (2009) Scirrhous hepatocellular carcinoma: comparison with usual hepatocellular carcinoma based on CT-pathologic features and long-term results after curative resection. Eur J Radiol 69(1):123–130PubMedCrossRef Kim SH, Lim HK, Lee WJ, Choi D, Park CK (2009) Scirrhous hepatocellular carcinoma: comparison with usual hepatocellular carcinoma based on CT-pathologic features and long-term results after curative resection. Eur J Radiol 69(1):123–130PubMedCrossRef
15.
Zurück zum Zitat Itai Y, Ohtomo K, Kokubo T, et al. (1986) CT of hepatic masses: significance of prolonged and delayed enhancement. AJR Am J Roentgenol 146(4):729–733PubMedCrossRef Itai Y, Ohtomo K, Kokubo T, et al. (1986) CT of hepatic masses: significance of prolonged and delayed enhancement. AJR Am J Roentgenol 146(4):729–733PubMedCrossRef
16.
Zurück zum Zitat Sajima S, Kinoshita H, Okuda K, et al. (1999) Angiomyolipoma of the liver—a case report and review of 48 cases reported in Japan. Kurume Med J 46(2):127–131PubMedCrossRef Sajima S, Kinoshita H, Okuda K, et al. (1999) Angiomyolipoma of the liver—a case report and review of 48 cases reported in Japan. Kurume Med J 46(2):127–131PubMedCrossRef
17.
Zurück zum Zitat Xu L, Shao Y, Zhang H, Wang H (2002) Hepatic angiomyolipoma: report of 8 cases and review of literature. Asian J Surg 25(1):82–86 ((discussion 7–8))PubMed Xu L, Shao Y, Zhang H, Wang H (2002) Hepatic angiomyolipoma: report of 8 cases and review of literature. Asian J Surg 25(1):82–86 ((discussion 7–8))PubMed
18.
Zurück zum Zitat Wang Z, Xu HX, Xie XY, et al. (2010) Imaging features of hepatic angiomyolipomas on real-time contrast-enhanced ultrasound. Br J Radiol 83(989):411–418PubMedCrossRef Wang Z, Xu HX, Xie XY, et al. (2010) Imaging features of hepatic angiomyolipomas on real-time contrast-enhanced ultrasound. Br J Radiol 83(989):411–418PubMedCrossRef
19.
Zurück zum Zitat Yoshida H, Itai Y, Ohtomo K, et al. (1989) Small hepatocellular carcinoma and cavernous hemangioma: differentiation with dynamic FLASH MR imaging with Gd-DTPA. Radiology 171(2):339–342PubMed Yoshida H, Itai Y, Ohtomo K, et al. (1989) Small hepatocellular carcinoma and cavernous hemangioma: differentiation with dynamic FLASH MR imaging with Gd-DTPA. Radiology 171(2):339–342PubMed
20.
Zurück zum Zitat Irie H, Honda H, Kuroiwa T, et al. (1999) Hepatic angiomyolipoma: report of changing size and internal composition on follow-up examination in two cases. J Comput Assist Tomogr 23(2):310–313PubMedCrossRef Irie H, Honda H, Kuroiwa T, et al. (1999) Hepatic angiomyolipoma: report of changing size and internal composition on follow-up examination in two cases. J Comput Assist Tomogr 23(2):310–313PubMedCrossRef
Metadaten
Titel
Hepatic angiomyolipoma: CT and MR imaging findings with clinical–pathologic comparison
verfasst von
Pei-qiang Cai
Yao-pan Wu
Chuan-miao Xie
Wei-dong Zhang
Rui Han
Pei-hong Wu
Publikationsdatum
01.06.2013
Verlag
Springer-Verlag
Erschienen in
Abdominal Radiology / Ausgabe 3/2013
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-012-9932-0

Weitere Artikel der Ausgabe 3/2013

Abdominal Radiology 3/2013 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.