CT and MR imaging of benign hepatic and biliary tumors

Karen M. Horton, David A. Bluemke, Ralph H. Hruban, Philippe Soyer, Elliot K. Fishman

Research output: Contribution to journalArticlepeer-review

215 Scopus citations


Benign hepatic and biliary tumors can present a difficult diagnostic challenge. Spiral computed tomography (CT) and magnetic resonance (MR) imaging are useful in the detection and characterization of these tumors. Imaging characteristics of lesions such as hepatic cyst, hemangioma, focal nodular hyperplasia (FNH), and hepatic adenoma are well known. Hepatic cysts demonstrate water attenuation at CT, are isointense relative to water at MR imaging, and do not enhance after intravenous administration of contrast material. Hemangiomas demonstrate characteristic nodular peripheral enhancement on early-phase images with subsequent fill-in centrally at both modalities. FNH classically demonstrates intense early enhancement with washout on delayed images. Although hepatic adenoma can also demonstrate intense early enhancement, it has a tendency to bleed and thus often appears more heterogeneous than FNH due to hemorrhage. Benign hepatic tumors that are less well described in the imaging literature include hepatic lipoma or angiomyolipoma, infantile hemangioendothelioma, and mesenchymal hamartoma. Hepatic lipoma has fat attenuation at CT, is isointense relative to fat at MR imaging, and does not enhance after intravenous administration of contrast material. Hepatic angiomyolipomas contain a variable amount of soft tissue in addition to fat and may therefore demonstrate enhancement at both modalities. The CT and MR imaging appearances of infantile hemangioma are similar to those of adult hemangioma. Infantile hemangioendothelioma occurs in infants under 6 months of age and is typically a larger lesion. Mesenchymal hamartoma also occurs in children, and its imaging appearance depends on the presence of stromal elements and the protein content of the cyst fluid. Familiarity with these imaging features can help distinguish particular disease entities.

Original languageEnglish (US)
Pages (from-to)431-451
Number of pages21
Issue number2
StatePublished - Jan 1 1999


  • Bile ducts, CT, 76.1211
  • Bile ducts, MR, 76.1214
  • Bile ducts, neoplasms, 76.31
  • Liver neoplasms, 761.31 Liver neoplasms, CT, 761.1211
  • Liver neoplasms, MR, 761.1214
  • Liver neoplasms, diagnosis, 761.1211, 761.1214

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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