肝脏增生结节的声像图类型与随访价值

Sonography and Result of Follow up in the Local Nodular Hyperplasia of Liver

报道１２例经临床及手术病理证实的肝脏结节性增生病灶的超声表现类型与随访结果。手术９例中５例病理报告不典型增生伴局灶性癌变、间变及异型增生。不典型增生是癌前病变，在本文随访中也证实此种观点。影像学检查无论ＣＴ、血管造影还是超声显像都存在困难，定期超声检查观察结节增长速度和形态，配合ＡＦＰ动态观察及增殖细胞核抗原标记指数增高，对预示癌变有较大帮助。

The ultrasonographic features and results of follow up in 12 patients with hepatic local nodular hyperplasia were reported. The diagnoses were confirmed by operation and pathology in 9 cases and by clinical pictures in 3 cases. Among the 9 operated patients, pathological examinations revealed atypical hyperplasia with local cancerous change, anaplasia and heteromorphic hyperplasia in 5 cases, thus atypical hyperplasia is a precancerous lesion, this view was also confirmed by the follow up of the patients. Difficultes existed to diagnose hepatic nodular hyperplasia by computer tomography, angiography and sonography, Observation of the rate of growth and morphology of the nodular hyperplasia detected by sonography, together with the monitoring of the change in AFP and the PCNA labeling index can help to predict cancerous lesion. In suspected cases, percutaneous biopsy under US guidance is essential.