Hepatocellular Adenomas: Correlation of MR Imaging Findings with Pathologic Subtype Classification
Hepatocellular Adenomas: Correlation of MR Imaging Findings with Pathologic Subtype Classification
复制标题
DOI：
10.1148/radiol.11110023
复制
发表时间：
2011-10-01
期刊：
影响因子：
19.7
通讯作者：
IJzermans, Jan N. M.
中科院分区：
文献类型：
--
作者：
van Aalten, Susanna M.;Thomeer, Maarten G. J.;IJzermans, Jan N. M.
目的：目的探讨肝细胞腺瘤（hepatocellular adenoma，HCA）的磁共振（MRI）表现与病理亚型的相关性。材料与方法：本回顾性研究经机构审查委员会批准，无需知情同意。61个病变（48例患者;中位年龄36岁）的MR成像研究可用，并由两名放射科医生独立审查。获得了所有形态学和信号强度成像特征的一致读数。以前，这些病变已被分类的病理结果和免疫组化分析的基础上。进行Fisher精确检验和卡方检验以比较不同亚型之间的结果。结果：9例肝脏脂肪酸结合蛋白（L-FABP）阴性HCA中有7例（78%）出现弥漫性瘤内脂肪沉积的MR成像征象，而29例炎性HCA中有5例（17%）出现弥漫性瘤内脂肪沉积的MR成像征象（P = 0.001）。29例炎性HCA中有11例（38%）出现非肿瘤性肝脏脂肪变性，而L-FABP阴性HCA中无一例出现（P = 0.038）。特征性环礁征仅见于炎症组（P = 0.027）。7例β-连环蛋白阳性HCA中有5例（71%）存在典型的模糊定义的瘢痕（P = 0.003）。未分类的cases.Conclusion：L-FABP阴性，炎性和β-catenin阳性的HCAs相关的MR成像征象的弥漫性瘤内脂肪沉积，环礁征，和一个典型的模糊定义的疤痕，分别。由于β-连环蛋白阳性的HCA被认为是癌前病变，因此更密切的随访可能是首选的MR成像或切除术。
Purpose: To investigate the correlation between magnetic resonance (MR) imaging findings and pathologic subtype classification of hepatocellular adenoma (HCA).Materials and Methods: This retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. MR imaging studies of 61 lesions (48 patients; median age, 36 years) were available and were independently reviewed by two radiologists. Consensus readings on all morphologic and signal-intensity imaging features were obtained. Previously, these lesions had been classified on the basis of pathologic findings and immunohistochemical analysis. Fisher exact and chi(2) tests were performed to compare the results between the different subtypes. A Bonferroni correction was applied to correct for multiple testing (alpha < .0033).Results: MR imaging signs of diffuse intratumoral fat deposition were present in seven (78%) of nine liver-fatty acid binding protein (L-FABP)-negative HCAs compared with five (17%) of 29 inflammatory HCAs (P = .001). Steatosis within the nontumoral liver was present in 11 (38%) of 29 inflammatory HCAs compared with none of the L-FABP-negative HCAs (P = .038). A characteristic atoll sign was only seen in the inflammatory group (P = .027). Presence of a typical vaguely defined type of scar was seen in five (71%) of seven beta-catenin-positive HCAs (P = .003). No specific MR imaging features were identified for the unclassified cases.Conclusion: L-FABP-negative, inflammatory, and beta-catenin-positive HCAs were related to MR imaging signs of diffuse intratumoral fat deposition, an atoll sign, and a typical vaguely defined scar, respectively. Since beta-catenin-positive HCAs are considered premalignant, closer follow-up with MR imaging or resection may be preferred.