肝脏局灶性结节增生影像表现(附6例报告)

Imaging Findings of Focal Nodular Hyperplasia Of The Liver(Reports of 6 Cases)

目的:通过回顾性总结7例临床病理确诊的肝脏局灶性结节增生的影像学表现,以期提高影像诊断的准确性,避免临床不必要的手术和有创的病理活检。材料与方法:收集我院手术或者病理活检临床确诊的7例共8个肝脏局灶性结节增生病灶的CT平扫,增强动脉期、门静脉期及平衡期图像以及MRI平扫、增强早期及增强晚期的图像。其中5例行CT及磁共振平扫及增强扫描,1例仅行磁共振平扫,对其影像学表现进行分析总结。结果:6例7个病灶,其中左叶2个病灶,右叶5个病灶。CT平扫病灶显示不清,增强动脉期表现为边界清晰车轮状明显强化结节,中心星芒状瘢痕强化不明显,门静脉期或延迟后病变逐渐为与邻近肝实质等密度结节,中心星芒状瘢痕延迟后明显强化,周边可见增粗迂曲的回流静脉血管影;MRIT1WI呈边界清晰的等信号或略低信号结节,中心星芒状瘢痕呈低信号;T2WI病灶为边界清晰的略高信号结节,中心条形或星芒状明显高信号影。增强T1WI脂肪抑制像表现和CT增强表现一致,早期轮辐状强化,延迟后呈等信号灶,中心瘢痕延迟后强化明显。结论:肝脏局灶性结节增生的CT和MRI表现具有一定的特征性,据此可以进行临床准确诊断,减少误诊。

Purpose： To evaluate CT and MR imaging findings of focal nodular hyperplasia （FNH） of the liver by clinical and pathological diagnosis, in order to improve the identification of FNH. To avoid unnecessary surgery and invasive biopsy. Materials and Methods： CT and MR plain and enhance scan in 5 cases of FNH, 1 cases only plain scan by MR . CT and MR appearances of FNH were retrospectively analysed in 6 cases （7 lesions）. Results： Two lesion in 6 cases（7 lesions） located in left lobe and five lesion in right lobe of liver. CT plain scan shous unclear lesion in 5 case. The parenchyma shows isointense to moderate hyperintense signal intensities on T2w images, and isointense to moderate hypointense signal intensities on TI w images in unenhaneed MRI. Six lesion is homogeneous enhancement with marked hyperintensity in the arterial phase is typical of FNH, whereas the central stellate area shows mild uptake enhancement in CT and MR enhance imaging. The central stellate scar consists of connective tissue and its typical feature is late enhancement on CT and MRI. Condusion： CT and MRI appearances of FNH of liver have certain characteristic.