Gd-EOB-DTPA-enhanced and diffusion-weighted magnetic resonance findings in hepatic epithelioid angiomyolipoma: A case report.

Abstract

The present study reports a case of histologically proven hepatic epithelioid angiomyolipoma that was evaluated with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging and diffusion-weighted imaging. A 23-year-old female was admitted to the Northern Jiangsu People's Hospital (Yangzhou, Jiangsu, China) due to a 5.6-cm mass in the liver, and a right partial hepatectomy was performed. Magnetic resonance imaging (MRI) revealed a hypointense mass on T1-weighted imaging, and a hyperintense mass on T2-weighted and diffusion-weighted imaging, with a higher apparent diffusion coefficient value compared with normal liver parenchyma. On the dynamic Gd-EOB-DTPA-enhanced MRI scan, the lesion manifested as hypervascular with multiple filiform vessels and a pseudocapsule image, and in the hepatobiliary phase the lesion demonstrated a lack of contrast retention, thus appearing hypointense compared with the background liver. Pre-operatively, EMAL was diagnosed on the basis of these findings in the tumor. The optimum treatment is complete surgical excision and subsequent follow-up. The patient was healthy and free from recurrence at 6 months and 1 year post-surgery. Therefore, knowledge of EAML specific features on dynamic Gd-EOB-DTPA-enhanced and DWI scans may improve the diagnostic accuracy of hypervascular hepatic tumors and may facilitate treatment selection.