Adenomatous Hyperplastic Nodules in the Cirrhotic Liver: Differentiation from Hepatocellular Carcinoma with MR Imaging

Differentiation of hepatocellular carcinomas from adenomatous hyperplastic nodules (AHNs) is important for the early and precise detection of hepatocellular carcinoma in the cirrhotic liver. For this purpose, the authors compared findings on magnetic resonance (MR) images of surgically resected AHNs (n = 7) with those of hepatocellular carcinoma (n = 47). AHNs were divided into two histologic groups: those without atypia (n = 5) and those with atypical hepatocytes or malignant foci (n = 2). All AHNs without atypia were hyperintense on T1-weighted spin-echo images and hypointense on T2-weighted spin-echo images relative to the surrounding liver. However, almost all hepatocellular carcinomas, except for two lesions with massive coagulation necrosis, were demonstrated as hyperintense on T2-weighted images. MR imaging may be useful in the differentiation of AHN without atypia from hepatocellular carcinoma in the cirrhotic liver.