The Gd-EOB-DTPA enhanced MRI features of hepatic angiomyolipoma and literature review

Objective: To analyze the Gd-EOB-DTPA enhanced MRI features of mixed type of hepatic angiomyolipoma. Methods: A 60 years old female patient with a hepatic nodular lesion which was accidentally found underwent plain MRI and Gd-EOB-DTPA enhanced MRI examination. Following surgical resection, a pathological diagnosis of hepatic angiomyolipoma was made. The clinical data, MRI appearances, and pathological findings of the lesion were analyzed retrospectively, and the relevant literatures were reviewed. Result: MRI showed a lesion at the top of the liver segment VIII with a size of 2.0 cm × 1.7 cm and a well-defined margin. The signal intensity of the lesion was slightly hypointense on in-phase T₁WI and heterogeneously reduced on opposed-phase T₁WI at the same level. The lesion was heterogeneous hyperintense on fat-suppressed T₂WI and slightly hyperintense on DWI. On Gd-EOB-DTPA enhanced T₁WI at early arterial phase, the lesion exhibited prominent hyperintense in an inhomogeneous manner, nearby a large blood vessel connecting the lesion with the branch of portal vein was identified. At late arterial phase and portal venous phase, the signal intensity of the lesion was slightly lower than that of the surrounding liver parenchyma. At equilibrium phase and delayed phase, the lesion exhibited heterogeneous hypointense. At 20 min and 50 min of the hepatobiliary phase, the lesion showed prominent hypointense. Conclusion: The Gd-EOB-DTPA enhanced MRI appearances of mixed-type of hepatic angiomyolipoma and hypervascular hepatocellular carcinoma overlap largely. Differential diagnosis should be made based on comprehensive analysis onclinical information, abdominal ultrasonography, and plain MRI findings. (authors)