Hepatocellular adenomas (HCA) present as four genetic
subtypes that vary greatly in their clinical behavior and MR appearance. Inflammatory HCA has the highest
propensity for hemorrhage, is characterized by hyperintense T2 signal, and
displays arterial hyper-enhancement that persists on portal venous and delayed
phases. HNF1-alpha mutated HCA
portends a good prognosis, and is characterized by diffuse intracellular
lipid. Beta-catenin HCA is less common and difficult to diagnose on
imaging, though arguably the most important because of its high likelihood for
malignant transformation. Unclassified HCA is not well understood in
terms of imaging or clinical significance.
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