| Objective To investigate the clinical value of high-field MR imaging in the differential atypical adenomatoid hyperplasia (AAH)nodules in cirrhosis.Methods The comprehensive imaging features of 23 cases (32 AAH) nodules confirmed pathologically were reviewed retrospectively and correlated with pathohistologic findings.Results 20 cases were diagnosed correctly and 3 cases were mistaken for small hepatocellular carcinomas (SHCC). 29 nodules showed high signal intensity and 3 nodules showed iso-intensity on T1WI and high intensity remained unchanged after using fat saturation, 27 nodules showed hypointense and 2 nodules showed iso-intensity and 3 nodules slight hyperintense on T2WI. Out of 20 patients with 20 AAH,18 showed slightly hyperintense and 2 showed isointense on in/out phase T1WI. Of 3 lesions in mistaken-diagnosed patients,2 were slightly hyperintense on in-phase T1WI,while 1 was hypointense on out-phase T1WI.On fat saturated T2WI,29 AAH were hypointense. In 3 mistaken-diagnosed SHCC on T2WI,2 were slightly hyperintense or heterogeneous intense,1 was hypointense.27 AAH showed (TypeⅡ) on Gd-DTPA enhanced scans account for 93% (27/29); In 3 mistaken-diagnosed SHCC ,2 showed obvious enhancement during arterial phase,decreased during the portal phase(Type I)on Gd-DTPA enhanced scans,account for 67% (2/3).Irregular reticular fibrous septum in 19 AAH showed slightly enhancement during delayed phase. Follow-up findings: 12 atypical adenomatoid hyperplasia nodule of the liver subsequently developed the SHCC within 2 years and 2 SHCC developed in the hepatic parenchyma after during 6-12 monthes resection of 2 atypical adenomatoid hyperplasia nodules.Conclusion Most of the AAH and SHCC can be distinguished by comprehensive analysis of the different sequence and Propeller LAVA,dynamic Gd—DTPA enhanced imaging. |
