肝局灶性结节增生的CT表现

CT profile of hepatic focal nodular hyperplasia

目的研究肝局灶性结节增生(FNH)在螺旋CT上的表现,提高CT诊断准确性。方法回顾性分析10例患者的临床、病理及影像学资料。5例行多层螺旋CT扫描;5例行单层螺旋CT扫描,其中3例只行增强扫描,2例只行平扫。结果CT共发现18个病灶,2例患者为多发。平扫CT上15个病灶中10个为低密度,5个是等密度;增强扫描动脉期,除了中央瘢痕和纤维分隔外,所有病灶都明显均匀强化;门脉期和延迟期大部分病灶变为等密度或略高密度,2个病灶变为略低密度。2个FNH病灶中发现中央瘢痕,1个病灶于动脉期中央及外周发现异常增粗、扭曲的动脉,于延迟期可见强化的假包膜。结论FNH在螺旋CT扫描上表现具有特征性,螺旋CT诊断FNH具有重要价值。

Objective To study the features of focal nodular hyperplasia（FNH） on helical computed tomography and to improve its diagnostic accuracy. Methods Clinical, pathologic and CT findings were retrospectively reviewed in 10 patients. Multislice helical CT was performed in 5 patients; single slice helical CT in 5 patients and among them, 3 got post-contrast scaning, 2 got pre-contrast scaning. Results CT found 18 tumors in 10 patients. Eight patients had single focus, while 2 patients had multiple FNH lesions. On pre-contrast scans, 10 of 15 lesions were hypodense, 5 of 15 were isodense. On the arterial phase scans, all the foci were markedly and homogeneously strengthemed except the central scar and septum areas. On the portal phase and delayed phase scans, 11 of 13 lesions changed to isodense or slightly hyperdense, 2 lesions slightly hypodense. Central scar was found in 2 FNH lesions. Tortuous and dilated arteries were found at the central and peripheral area in 1 lesion on arterial phase, enhanced pseudocapsule was showed in 1 lesion on delayed phase. Conclusion Helical CT demonstrates characteristic features of FNH, it is of great value in diagnosing FNH.