Sonographic features of hepatic adenomas with pathologic correlation

Background: We compared the sonographic characteristics of hepatic adenomas with pathologic findings. Methods: Information over 10 years was collected on 12 patients (six men, six women; mean age = 47 years) with surgically proven hepatic adenomas. Clinical data, sonographic features, and histopathologic findings were reviewed. Results: The tumors in males were smaller and simpler than those in women (p < 0.05, Fisher's exact test). Four of the six larger tumors (>5 cm) showed mixed-echoic patterns corresponding with pathologically intratumoral hemorrhage and necrosis. Four homogeneously hypoechoic tumors had less change in tumor composition. Three homogeneously hyperechoic tumors had evident fatty changes: inside. One isoechoic tumor had a hypoechoic rim, that correlated mostly to the tumor itself and compressed liver parenchyma, Seven of the 12 tumors had thin fibrous capsules that were not seen on sonography. Conclusion: Hepatic adenomas have variable sonographic appearances depending on changes in the tumor. Hypoechoic, hyperechoic, and mixed-echoic patterns represent simple adenoma, adenoma with fatty metamorphosis, and hemorrhagic necrosis, respectively, in tumors.