肝脏局灶性结节增生的MSCT研究

MSCT study on focal nodular hyperplasia in liver

目的应用MSCT多期扫描研究肝脏局灶性结节增生(focal nodular hyperplasia,FNH),探讨其诊断及鉴别诊断的价值。方法使用东芝Aquilion 16层螺旋CT对临床证实的肝FNH12例病人行平扫和增强多期扫描,显示病灶形态和增强特点,并作3-D血管重建,进行综合影像学分析。结果12例中11例为单发病灶,另1例多发(2个病灶)。CT平扫8个病灶呈低密度,4个为等密度,1个为高密度。对比增强特点:所有病灶动脉期均快速显著均匀增强。门静脉期及延迟期9例为等密度,4例为稍高密度。8个病灶检出中央瘢痕,其中6例门静脉期及延迟期瘢痕面积减少或消失,2例延迟期瘢痕呈稍高密度强化。血管重建可见主要来自肝动脉(其中一例来自肝外血管)的较粗大供血动脉。结论FNH在MSCT平扫及多期增强扫描中有特征性表现,MSCT可为FNH的诊断及鉴别诊断提供关键依据。

Objective To investigate the diagnosis and differential diagnosis of hepatic Focal Nodular Hyperplasia （FNH） by means of applying MSCT scans in multiple phases. Methods T welve patients with hepatic FNH were undergone on MSCT dynamic scans in multiple phases, of which the shape and enhancing process of lesions were exhibited and their vessels to the focuses were 3-d reconstructed. All imaging data were synthetically analyzed. Results In total 12 cases 11 patients were of single lesion, and another one was of multiple lesions（2 lesions）. On plain scans, 8 lesions showed hypodensity, 4 lesions isodensity and 1 lesion hyperdensity. After contrast, all lesions were markedly and homogeneously enhanced in arterial phase but in portal and delayed phase 9 cases displayed isodensity, other 4 displayed slightly hyper-density. There were 8 cases found with central scar in these lesions, among them 6 scars were decreased in area or even disappeared in portal or delay period and other 2 scars were increased in density in delayed phase. There can be seen some thickened supply arteries mainly derived from hepatic artery in 3-d reconstruction. Conclusion FNH were demonstrated imaging traits on MSCT plain and dynamic contrast scans in multiple phases; Therefore MSCT could provided vital proof for diagnosis and differential diagnosis of hepatic FNH.