Presentation
Asymptomatic patient diagnosed with multiple hepatic focal lesions on a routine US examination. She had no significant personal or family medical history. A gadoxetic-acid-enhanced (Primovist) hepatic MR was performed for further characterization of the lesions.
Patient Data
Hepatic MRI shows multiple focal lesions, heterogeneous in size, affecting both hepatic lobes. Most of them are T1-isointense and T2-hyperintense compared to normal background liver parenchyma. On chemical shift sequences, diffuse signal drop-off is noted within the lesions during the opposed phase. Lesions show no significant hepatobiliary-specific contrast agent uptake. Only mild diffusion restriction is seen in the largest lesions.
Case Discussion
Findings were consistent with hepatic adenomatosis, arbitrarily defined as the presence of >10 hepatocellular adenomas affecting both lobes of the liver. No biopsy was performed due to the risk of hemorrhage and the typical radiological findings. The patient refused hepatic transplant, and lesions were stable in later MRI examinations.
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