Diagnosis of hepatobiliary cystadenoma and cystadenocarcinoma with CT and MRI

Objective To summarize the CT and MRI findings of hepatobiliary cystadenoma and cystadenocarcinoma and determine tbeir value for diagnosis of the 2 diseases. Methods Three cases of cystadenoma and 5 cases of cystadenocareinoma were diagnosed by CT and MRI and confirmed by op eration and pathology. Plain and enhanced CT scanning, plain and multiphase enhanced MRI and CT in combination with MRI were performed in 3, 3 and 2 cases, respectively. The CT and MRI features of the 8 eases were retrospectively analyzed and their correlation to pathological findings determined. Results Histological evidence showed that there were 3 cases of cystadenoma, 2 of cystadenoma with focal canceration and 3 of cystadenocarcinoma. All the 3 eases of cystadenoma were solitary cystic le sion without mural nodule. The 2 cases of cystadenoma with focal canceration and 3 of cystadenocarei noma were unilocular or multilocular cystic lesions with multiple mural nodules. One case of cystade noma with focal canceration was multiple. Mural nodules and irregular thickening of cystic walls were found in all the malignant cases. The cystic part of the lesions in all the 8 cases were of homogenous low-attenuation or low-signal intensity on T1WI and high signal intensity on T2WI. In enhanced CT or MRI. the mural nodules and cyst wall and/or septa were enhanced. Conclusion CT and MRI can be used to reveal the features of cystadenocarcinoma. Therefore. accurate preoperative diagnosis of cystadenocarcinoma can be made. However, the benign eystadenoma without mural nodule lacks char acteristic CT and MRI finds, thus it is easy to be misdiagnosed as hepatic cyst or hydatid cyst.