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Abdominal Radiology
Published in: Abdominal Radiology 2/2014

01-04-2014

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

Authors: Sheng-yu Wang, Xin-ping Kuai, Xiao-xi Meng, Ning-yang Jia, Hui Dong

Published in: Abdominal Radiology | Issue 2/2014

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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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Metadata
Title
Comparison of MRI features for the differentiation of hepatic angiomyolipoma from fat-containing hepatocellular carcinoma
Authors
Sheng-yu Wang
Xin-ping Kuai
Xiao-xi Meng
Ning-yang Jia
Hui Dong
Publication date
01-04-2014
Publisher
Springer US
Published in
Abdominal Radiology / Issue 2/2014
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-013-0070-0

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