Abstract：
BACKGROUND: The goal of medical imaging is not only to identify the entity \"hepatocellular adenoma,\" but to detect typical magnetic resonance (MR) patterns of the subtypes so that lesions with a higher malignant transformation rate could be differentiated from those that should just be controlled.
OBJECTIVE: To evaluate the differentiation between subtypes of hepatocellular adenomas using hepatobiliary specific contrast agent (Gd-EOB-DTPA) in MR imaging.
METHODS: A total of 11 patients with 39 lesions with histologically proven hepatocellular adenomas were evaluated. Of the, 34 were inflammatory hepatocellular adenomas (IHCA) and 5 were HNF1α adenomas. No β-catenin-mutated adenoma was found. In all patients, a standard protocol considering the guidelines of the international consensus conference of Gd-EOB-DTPA was performed in a 1.5-T scanner. Besides a qualitative analysis of all sequences, we measured the quantitative signal intensity (SI) ratio in all examinations.
RESULTS: Qualitative analysis showed that best sequences for differentiation of HNF1α adenomas from IHCA were T1-weighted (T1W) precontrast (P = 0.03) and portalvenous phase (P < 0.0001) as well as arterial phase (P = 0.002). All adenomas were hypointense in hepatobiliary phase (15 min). The quantitative analyses of the SI ratio and of lesion-to-liver contrast (LLC) ratio show statistically significant differences in T1W precontrast (SI: P = 0.035; LLC: P = 0.049) and portalvenous phase (SI: P = 0.002; LLC: P = 0.002).
CONCLUSIONS: Subtyping of hepatocellular adenomas using Gd-EOB-DTPA is possible due to qualitative and quantitative analyses regarding T1W precontrast and portalvenous phase. In addition, the SI ratio and liver-to-lesion contrast ratio in the arterial phase gave additional qualitative information for differentiation.
OBJECTIVE: To evaluate the differentiation between subtypes of hepatocellular adenomas using hepatobiliary specific contrast agent (Gd-EOB-DTPA) in MR imaging.
METHODS: A total of 11 patients with 39 lesions with histologically proven hepatocellular adenomas were evaluated. Of the, 34 were inflammatory hepatocellular adenomas (IHCA) and 5 were HNF1α adenomas. No β-catenin-mutated adenoma was found. In all patients, a standard protocol considering the guidelines of the international consensus conference of Gd-EOB-DTPA was performed in a 1.5-T scanner. Besides a qualitative analysis of all sequences, we measured the quantitative signal intensity (SI) ratio in all examinations.
RESULTS: Qualitative analysis showed that best sequences for differentiation of HNF1α adenomas from IHCA were T1-weighted (T1W) precontrast (P = 0.03) and portalvenous phase (P < 0.0001) as well as arterial phase (P = 0.002). All adenomas were hypointense in hepatobiliary phase (15 min). The quantitative analyses of the SI ratio and of lesion-to-liver contrast (LLC) ratio show statistically significant differences in T1W precontrast (SI: P = 0.035; LLC: P = 0.049) and portalvenous phase (SI: P = 0.002; LLC: P = 0.002).
CONCLUSIONS: Subtyping of hepatocellular adenomas using Gd-EOB-DTPA is possible due to qualitative and quantitative analyses regarding T1W precontrast and portalvenous phase. In addition, the SI ratio and liver-to-lesion contrast ratio in the arterial phase gave additional qualitative information for differentiation.
摘要：
背景：医学成像的目标不仅是识别实体“肝细胞腺瘤”，“但要检测亚型的典型磁共振（MR）模式，以便可以将具有较高恶性转化率的病变与应该控制的病变区分开来。
目的：在MR成像中使用肝胆特异性造影剂（Gd-EOB-DTPA）评估肝细胞腺瘤亚型之间的区别。
方法：共评估了11例经组织学证实的39个病灶的肝细胞腺瘤患者。Ofthe,34例为炎性肝细胞腺瘤(IHCA),5例为HNF1α腺瘤。未发现β-连环蛋白突变的腺瘤。在所有患者中，采用Gd-EOB-DTPA国际共识会议指南的标准方案在1.5T扫描仪中进行.除了对所有序列进行定性分析之外，我们测量了所有检查中的定量信号强度（SI）比。
结果：定性分析表明，从IHCA中区分HNF1α腺瘤的最佳序列是T1加权（T1W）前对比（P=0.03）和门脉期（P<0.0001）以及动脉期（P=0.002）。所有腺瘤在肝胆期（15分钟）均为低信号。SI比率和病变与肝脏对比剂（LLC）比率的定量分析显示，T1W对比剂（SI：P=0.035；LLC：P=0.049）和门脉期（SI：P=0.002；LLC：P=0.002）具有统计学意义。
结论：使用Gd-EOB-DTPA对肝细胞腺瘤进行分型是可能的，因为对T1W前对比和门静脉期进行了定性和定量分析。此外,动脉期的SI比率和肝脏与病变的对比比率为分化提供了额外的定性信息.
目的：在MR成像中使用肝胆特异性造影剂（Gd-EOB-DTPA）评估肝细胞腺瘤亚型之间的区别。
方法：共评估了11例经组织学证实的39个病灶的肝细胞腺瘤患者。Ofthe,34例为炎性肝细胞腺瘤(IHCA),5例为HNF1α腺瘤。未发现β-连环蛋白突变的腺瘤。在所有患者中，采用Gd-EOB-DTPA国际共识会议指南的标准方案在1.5T扫描仪中进行.除了对所有序列进行定性分析之外，我们测量了所有检查中的定量信号强度（SI）比。
结果：定性分析表明，从IHCA中区分HNF1α腺瘤的最佳序列是T1加权（T1W）前对比（P=0.03）和门脉期（P<0.0001）以及动脉期（P=0.002）。所有腺瘤在肝胆期（15分钟）均为低信号。SI比率和病变与肝脏对比剂（LLC）比率的定量分析显示，T1W对比剂（SI：P=0.035；LLC：P=0.049）和门脉期（SI：P=0.002；LLC：P=0.002）具有统计学意义。
结论：使用Gd-EOB-DTPA对肝细胞腺瘤进行分型是可能的，因为对T1W前对比和门静脉期进行了定性和定量分析。此外,动脉期的SI比率和肝脏与病变的对比比率为分化提供了额外的定性信息.
