误诊为肝癌的肝局灶结节增生的超声表现及分析

The Sonographic Features of Liver Focal Nodular Hyperplasia and the Cause of Misdiagnosis as Hepatic Cell Cancer

[目的]探讨误诊为肝癌的肝局灶结节增生(FNH)的超声表现及误诊原因。[方法]回顾性分析23例肝局灶结节增生超声误诊为肝癌的超声表现。[结果]低回声肿物13例,稍高回声6例,等回声4例;肿物回声均匀13例,回声不均匀10例;有晕环8例;均未见中心星状高回声;彩色多普勒超声检测到血流信号14例,其中有中心血流信号10例,均无放射状血流分支。病理见23例肝局灶结节增生中9例剖面可见中心或偏心瘢痕。14例病灶内未见星状瘢痕。[结论]肝局灶结节增生回声不均,有晕环,未检出中心及分支血流信号是误诊主要原因,认识其病理分型,结合临床有助于减少误诊。

[Purpose] To investigate the cause of misdiagnosis of liver focal nodular hyperplasia（FNH） as hepatic cell cancer（HCC） by sonography.[Methods] The sonographic findings of 23 cases with liver FNH misdiagnosed as HCC were analyzed.[Results] In all 23 masses,13 were hypoechoic,six were hyperechoic and 4 were isoechoic.Ten masses were heterogeneous,13 masses were hemogeneous.Eight masses had hypoechoic halo;none showed central hyperechoic scar.Of 14 masses blood flow signal detected by color Doppler sonography,central blood flow signal showed in 10,and no one with radiating blood flow signal.Nine FNHs pathologically showed central/eccentral scar.[Conclusions] Heterogeneous echo patterns,hypoechoic halo,no central blood flow are the main reasons for misdiagnosis of FNH.Combination of pathological and clinical features of FNH mag improve the accuracy of diagnosis.