肝细胞腺瘤是一类与不同预后相关的肝肿瘤家族。自这些肿瘤最初被描述以来，肝细胞腺瘤的分类已经扩展，现在根据分子分析结果包括八种不同的基因型亚型。这些基因型亚型有其独特的细胞生物学失常，决定了它们的临床病程，并可能允许非侵入性鉴别某些亚型。利用肝胆造影剂进行多相MRI仍然是非侵入性检测、表征和监测肝细胞腺瘤的最佳方法。肝细胞腺瘤一般在肝胆期呈低信号强度；β-连环蛋白突变第3外显子亚型和多达三分之一的炎症性肝细胞腺瘤是这种表现的例外。重要的是，了解肝细胞腺瘤超过MRI的出现形式，因为这些肿瘤通常是最初通过其他成像方式识别的。最担心的两种相关并发症是出血和恶性转化为肝细胞癌，虽然这些并发症的风险取决于肿瘤大小、亚型和临床因素。对于持续大于5厘米的肝细胞腺瘤、男性中的所有腺瘤以及所有β-连环蛋白突变的第3外显子肝细胞腺瘤，建议进行择期手术切除。热消融和经动脉栓塞是手术切除的潜在替代方法。在急性破裂的肝细胞腺瘤的情况下，患者通常进行经动脉栓塞治疗，有时延迟手术切除。这篇有关肝细胞腺瘤的更新包括按亚型和成像模式进行放射病理学相互关系的回顾、相关并发症和管理建议。© RSNA，2023年在线补充材料可供本文使用。通过在线学习中心可获得本文的测验问题。

Hepatocellular adenomas (HCAs) are a family of liver tumors that are associated with variable prognoses. Since the initial description of these tumors, the classification of HCAs has expanded and now includes eight distinct genotypic subtypes based on molecular analysis findings. These genotypic subtypes have unique derangements in their cellular biologic makeup that determine their clinical course and may allow noninvasive identification of certain subtypes. Multiphasic MRI performed with hepatobiliary contrast agents remains the best method to noninvasively detect, characterize, and monitor HCAs. HCAs are generally hypointense during the hepatobiliary phase; the β-catenin-mutated exon 3 subtype and up to a third of inflammatory HCAs are the exception to this characterization. It is important to understand the appearances of HCAs beyond their depictions at MRI, as these tumors are typically identified with other imaging modalities first. The two most feared related complications are bleeding and malignant transformation to hepatocellular carcinoma, although the risk of these complications depends on tumor size, subtype, and clinical factors. Elective surgical resection is recommended for HCAs that are persistently larger than 5 cm, adenomas of any size in men, and all β-catenin-mutated exon 3 HCAs. Thermal ablation and transarterial embolization are potential alternatives to surgical resection. In the acute setting of a ruptured HCA, patients typically undergo transarterial embolization with or without delayed surgical resection. This update on HCAs includes a review of radiologic-pathologic correlations by subtype and imaging modality, related complications, and management recommendations. © RSNA, 2023 Online supplemental material is available for this article. Quiz questions for this article are available through the Online Learning Center.