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Multiple biliary hamartomas: magnetic resonance features with histopathologic correlation.

Carla Tohmé-Noun1, Dominique Cazals, Roger Noun

  • 1Department of Radiology, Beaujon Hospital, Assistance Publique, Clichy, France. rnoun@wise.net.lb

European Radiology
|October 16, 2007
PubMed
Summary

Magnetic resonance imaging (MRI) accurately diagnoses multiple biliary hamartomas (MBH) by identifying characteristic lesion features. Recognizing these MRI findings, particularly mural nodules, is crucial for avoiding misdiagnosis of this liver condition.

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Area of Science:

  • Hepatobiliary Imaging
  • Gastrointestinal Radiology
  • Diagnostic Imaging

Background:

  • Multiple biliary hamartoma (MBH) is a rare congenital liver malformation.
  • Accurate diagnosis of MBH is essential to differentiate it from other liver lesions.
  • Histopathological correlation is the gold standard for MBH diagnosis.

Purpose of the Study:

  • To describe the magnetic resonance imaging (MRI) features of multiple biliary hamartoma (MBH).
  • To correlate MRI findings of MBH with histopathological results.
  • To assess the diagnostic accuracy of MRI for MBH.

Main Methods:

  • Retrospective review of MRI features in 11 patients with histologically proven MBH.
  • Correlation of MRI findings (T1, T2, contrast-enhanced sequences, MR cholangiography) with histopathology.

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  • Analysis of lesion characteristics, including distribution, signal intensity, and mural nodules.

    • Main Results:

    • MBH appeared as multiple, tiny, uniformly distributed lesions, hypointense on T1 and hyperintense on T2-weighted images.
    • Mural nodules were present in 91% of cases, showing isosignal on T1 and intermediate signal on T2, with enhancement after gadolinium administration in 90%.
    • MR cholangiography showed no communication with the biliary tree; histopathology confirmed mural nodules as endocystic polypoid projections.

    Conclusions:

    • MRI is a highly accurate modality for diagnosing multiple biliary hamartoma.
    • Characteristic MRI features, especially the presence and enhancement of mural nodules, aid in diagnosis.
    • Accurate recognition of MBH on MRI can prevent misdiagnosis and unnecessary interventions.