无瘢痕肝脏局灶性结节增生的CT表现

CT imaging features of focal nodular hyperplasia without scar

目的:探讨无瘢痕局灶性结节增生(FNH)和有瘢痕FNH的CT表现差异。方法:将63个FNH病灶分为无瘢痕组(17个)和瘢痕组(46个),比较两组病灶的CT表现、各扫描期相平均CT值、CT强化值、强化特点差异。结果:无瘢痕FNH最大径≤3 cm者占88.2%(15/17),瘢痕FNH最大径>3 cm者占87.0%(40/46)。无瘢痕组和瘢痕组的假包膜出现率分别为23.5%和60.9%,增粗供血动脉显示率分别为5.9%和76.1%。两组病灶均呈"快进慢出"的强化改变,但无瘢痕组的密度不均匀比例较高。4个无瘢痕FNH和7个瘢痕FNH病灶在CT增强扫描中均可见"中心开花式"强化。无瘢痕FNH增强三期的平均CT值和CT强化值均低于瘢痕FNH组(P均<0.05)。结论:无瘢痕FNH病灶多较小,假包膜及供血动脉的显示率均低于瘢痕FNH,强化亦稍低于瘢痕者。

Objective:To analyze the CT imaging features of focal nodular hyperplasia without scar(scarless-FNH)and scarred-FNH.Methods:63 FNH lesions were categorized two types:scarless-FNH(17 lesions)and scarred-FNH group(46 lesions).CT attenuation and enhancement characteristics were evaluated.Results:88.2%of scarless-FNH lesions were equal or less than 3 cm,while 87%of scarred-FNH lesions were larger than 3 cm.23.5%and 60.9%of pseudocapsule was visualized in scarless-FNH and scarred-FNH group,respectively.Feeding arteries were identified in 5.9%and 76.1%for scarless-FNH and scarred-FNH group,respectively.They both showed"wash-in and slow-out"enhancing,but scarless-FNH tend to be more inhomogeneous.4 scarless-FNH and 7 scarred-FNH lesions showed"central blooming"enhancement.CT attenuation and enhancement values of scarless-FNH in three-phase enhancement group were lower than those of scarred-FNH group,respectivelly(P<0.05).Conclusion:Scarless-FNH tend to show smaller size,less pseudocapsule and feeding artery,and decreased enhancement compared with scarred-FNH.