肝脏局灶性结节增生的CT和MRI表现与病理对照分析

Focal Nodular Hyperplasia of the Liver:Comparative Study between CT,MRI and Pathology

目的:探讨肝脏局灶性结节增生(FNH)的CT和MRI表现及病理基础。方法:回顾性分析18例20个经手术或穿刺活检病理证实FNH的CT和MRI表现特点,并与病理对照(CT检查12例,MRI检查10例,4例同时行CT和MRI检查)。结果:病灶大小1.8～13.5cm;CT检出11个病灶,CT平扫病灶均呈低密度,均匀或不均匀;增强扫描动脉期示除中心疤痕灶外,所有病灶均明显增强,6个病灶周边见增粗、扭曲的动脉;门脉期示病灶呈稍高密度,延时期示6个病灶呈稍高或等密度,5个病灶呈稍低密度;5个病灶的中央疤痕均延时增强。MRI检出12个病灶,病灶均呈稍长或等T1及T2信号;增强动脉期示病灶明显增强,门脉期及延时期呈稍高或等信号,7个病灶的中央疤痕延时增强。结论:CT和MRI能够显示FNH的血供特点及病理特征,动态增强扫描是诊断FNH最有效的影像学手段,在诊断和鉴别诊断中具有很大价值。

Objective：To evaluate the CT and MRI findings of hepatic focal nodular hyperplasia （FNH） correlating with pathologic basis. Methods：The CT and MRI findings of 20 patients pathologically confirmed FNH in 18 patients were retrospectively studied and compared with pathological features. Twelve patients were examined by CT, 10 patients by MRI, and 4 patients had both CT and MRI examinations. Results：The size of lesions ranged from 1.8- 13.5cm. CT found 11 lesions. On precontrast CT, the lesions showed heterogeneous or homogeneous hypo-density. On postcontrast CT, the lesions showed intense and homogeneous enhancement during arterial phase,except for 5 lesions with the central scar. Tortuous and dilated arteries were erected around 6 lesions. During portal vein phase, the lesions showed moderate hyper- density. During delayed phase,6 lesions remained mild hyper-density or isodensity and 5 lesions showed hypodensity. 5 lesions with central scars demonstrated delayed enhancement. On MR imaging,12 lesions showed slightly long or iso-T1 and T2 signal intensity,demonstrating intense arterial enhancement and moderate portal and delay enhancement on Gd-DTPA contrast studies. Central scar sign 7 lesions showed delayed enhancement. Conclusion： CT and MRI play important roles in the demonstration of blood supply and pathological features of FNH. Dynamic contrast enhancement has a great value in the diagnosis and differential diagnosis of FNH.