Hepatocellular adenomas: Understanding the pathomolecular lexicon, MRI features, terminology, and pitfalls to inform a standardized approach

Abstract

Hepatocellular adenomas (HCAs) are benign hepatic tumors that can be complicated by bleeding and/or malignant transformation. The epidemiology of HCAs has changed over recent decades, primarily influenced by an increased incidence of obesity in both men and women. Currently, at least eight distinct pathomolecular subtypes of HCAs have been identified, several of which have distinguishing and pertinent imaging features on MRI. Emerging evidence suggests that hepatobiliary phase appearance may provide diagnostic and prognostic information. The purpose of this article is to review the current pathomolecular lexicon and imaging features with emphasis on hepatobiliary phase appearance. Level of Evidence: 5 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2020;51:1630-1640.

Keywords: HCA subtypes; MRI; hepatobiliary contrast imaging; hepatocellular adenoma.