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Multiple Hepatic Adenomas Associated with Liver Steatosis at CT and MRI: A Case-Control Study

Alessandro Furlan1,2, Dirk J. van der Windt3, Michael A. Nalesnik4, Biatta Sholosh1, Ka-Kei Ngan1, Karen M. Pealer1, Jan N. M. Ijzermans3 and Michael P. Federle1

1 Department of Radiology, University of Pittsburgh Medical Center (Presbyterian Campus), Pittsburgh, PA.
2 Present address: Instituto di Radiologia, Azienda Ospedaliero-Universitaria "Santa Maria della Misericordia" di Udine, Via Colugna 50, 33100 Udine (UD), Italy.
3 Department of Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
4 Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.


Figure 1
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  		Fig. 1A —31-year-old woman with multiple hepatic adenomas and liver steatosis. Transverse unenhanced CT scan shows two small hepatic adenomas (arrows) in right and left lobes of liver. Nodules appear hyperattenuating compared with surrounding liver parenchyma because of diffuse hepatic steatosis.

 

Figure 2
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  		Fig. 1B —31-year-old woman with multiple hepatic adenomas and liver steatosis. Transverse contrast-enhanced CT scan corresponding to A shows persistent enhancement of hepatic adenomas (arrows). Five additional lesions with identical characteristics were identified (not shown).

 

Figure 3
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  		Fig. 2A —35-year-old woman with multiple hepatic adenomas and liver steatosis presenting with abdominal pain. Transverse in-phase MR image (TR/TE, 145/4.2) shows biopsy-proven hepatic adenoma (arrow) as slightly hypointense lesion in right liver lobe.

 

Figure 4
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  		Fig. 2B —35-year-old woman with multiple hepatic adenomas and liver steatosis presenting with abdominal pain. Transverse opposed-phase MR image (145/2.1) corresponding to A shows signal drop of liver parenchyma due to fat deposition and "sparing" of area (arrowheads) surrounding hyperintense adenoma (arrow).

 

Figure 5
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  		Fig. 2C —35-year-old woman with multiple hepatic adenomas and liver steatosis presenting with abdominal pain. Transverse gadolinium-enhanced arterial phase T1-weighted gradient-echo MR images (4.0/1.8) at two different hepatic levels show enhancement of adenoma (arrow, C) associated with transient hepatic intensity defect (arrowheads, C) and two additional small lesions (arrows, D) with identical imaging characteristics; these characteristics are compatible with those of other small hepatic adenomas.

 

Figure 6
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  		Fig. 2D —35-year-old woman with multiple hepatic adenomas and liver steatosis presenting with abdominal pain. Transverse gadolinium-enhanced arterial phase T1-weighted gradient-echo MR images (4.0/1.8) at two different hepatic levels show enhancement of adenoma (arrow, C) associated with transient hepatic intensity defect (arrowheads, C) and two additional small lesions (arrows, D) with identical imaging characteristics; these characteristics are compatible with those of other small hepatic adenomas.

 

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