Moradi Zahra, Khalaj Fattaneh, Soltani Setareh, Ghorani Hamed, Ranjbar Ehsan, Tabatabaei Mahgol Sadat Hassan Zadeh, Ayoobi Yazdi Niloofar, Salahshour Faeze
Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
Abdom Radiol (NY). 2025 Jul 28. doi: 10.1007/s00261-025-05106-4.
Hepatocellular adenomas are rare benign liver tumors primarily affecting young women, particularly those using oral contraceptives. This systematic review and meta-analysis aimed to evaluate the radiologic features of beta-catenin mutated HCAs with a focus on enhancing diagnostic accuracy and informing management strategies. A comprehensive search of databases yielded 328 articles, with 13 meeting inclusion criteria. The analysis included 94 B-HCAs, revealing a mean size of 6.46 cm and a notable prevalence of necrosis (32.65%). Imaging characteristics demonstrated that T1-weighted MRI showed isointensity in 47% and hypointensity in 36% of lesions, while T2-weighted MRI indicated iso-mild hyperintensity in 60% and hyperintensity in 38%. In the arterial phase, 87% of lesions exhibited hyperenhancement. The presence of a central scar was noted in 47.05% of cases, while the atoll sign and intralesional hemorrhage were less common. The study found a significant tendency for malignant transformation, with 47.72% of B-HCAs evolving into malignant lesions. The findings suggest that B-HCAs may present features similar to focal nodular hyperplasia, complicating diagnosis. Given the high risk of malignancy, management strategies for B-HCAs should align with those for hepatocellular carcinoma. This review underscores the importance of comprehensive MRI evaluation and clinical context in diagnosing B-HCAs, advocating for cautious interpretation of imaging findings to guide potential biopsy decisions.
肝细胞腺瘤是一种罕见的肝脏良性肿瘤，主要影响年轻女性，尤其是那些使用口服避孕药的女性。本系统评价和荟萃分析旨在评估β-连环蛋白突变型肝细胞腺瘤的放射学特征，重点是提高诊断准确性并为管理策略提供依据。对数据库进行全面检索后得到328篇文章，其中13篇符合纳入标准。分析纳入了94例β-连环蛋白突变型肝细胞腺瘤，其平均大小为6.46厘米，坏死发生率较高（32.65%）。影像学特征显示，T1加权磁共振成像（MRI）显示47%的病灶呈等信号，36%呈低信号，而T2加权MRI显示60%的病灶呈等-轻度高信号，38%呈高信号。在动脉期，87%的病灶表现为强化。47.05%的病例可见中央瘢痕，而环岛征和瘤内出血则较少见。研究发现存在显著的恶性转化倾向，47.72%的β-连环蛋白突变型肝细胞腺瘤演变为恶性病变。研究结果表明，β-连环蛋白突变型肝细胞腺瘤可能呈现与局灶性结节性增生相似的特征，使诊断复杂化。鉴于恶性风险高，β-连环蛋白突变型肝细胞腺瘤的管理策略应与肝细胞癌的管理策略一致。本综述强调了在诊断β-连环蛋白突变型肝细胞腺瘤时进行全面MRI评估和结合临床背景的重要性，提倡谨慎解读影像学结果以指导潜在的活检决策。
