肝脏局灶性结节增生的MR表现及病理对照研究

MRI Findings of Hepatic Focal Nodular Hyperplasia:Comparative Study with Pathology Correlation

目的:探讨肝脏局灶性结节增生(FNH)的MRI表现及其病理基础。方法:回顾性分析26例手术病理证实的FNH患者MRI平扫(T1WI、T2WI及DWI)和动态增强扫描的资料,对病灶信号及强化特点进行评价。结果:26例共33个病灶,单发型23例,多发型3例。实质部分于T1WI显示31例,其中低信号3例、略低信号28例;T2WI显示32例,其中略高信号25例,高信号7例;DWI显示29例,其中略高信号21例,高信号8例。共21例病灶显示中央瘢痕,其中T1WI显示19例,均为低信号;T2WI均可显示,且均呈高信号;DWI显示15例,均为高信号。增强后,实质部分均于动脉期明显、均匀强化,延迟扫描呈略高信号28例,等信号4例,略低信号1例。中央瘢痕于动脉期明显强化1例,延迟期仍持续强化,余32例均表现为延迟强化。8例病灶周围可见增粗、扭曲的供血动脉,4例病灶周围见不完整的环形包膜样延迟强化影。结论:MRI能全面展示FNH病理改变及血流动力学特征,DWI可以提供辅助诊断信息。

Purpose： To investigate the imaging findings of hepatice focal nodular hyperplasia（FNH） . Methods ： The MRI data of 26 patients with pathologically confirmed FHN were retrospectively analyzed. The signal intensity of FNH at TIWI, T2WI as well as diffusion - weighted imaging and enhancement pattern was evaluated. Results： Total 33 lesions were detected in 26 patients. Twenty three had 1 lesion each, and the remaining 3 had multiple lesions. Solid components of FNH showed hypointensity （3/31） or slightly hyperintensity （28/31） on TlWI and slightly hyperintensity （25/32） or hyperintensity （7/32）on T2WI. Central scars were found in 21 lesions which showed hypointensity （19/21） on TiWI and hyper intensity （21/21） on T2WI relative to the solid components. Twenty- nine lesions were visible on DWI, solid components of them showed slightly hyper - intensity （21/29） or hypo - intensity （8/29） relative surrounding liver parenchyma. Central scans of 15 of them displayed hyper intense on DWI. After con trast administration, lesions showed marked, homogeneously enhancement during arterial phase. During the delayed phase, they showed slightly hyper intensity （28/33） or iso - intensity （28/33）, iso inten sity （4/33） or slightly hypointensity （1/33） on delayed phase. Central scars showed delayed enhancement in 32 of 33 lesions. Tortuous and dilated feeding arteries were detected in 8 lesions.Four lesions were revealed uncomplete rim like enhancement in the delayed phase. Conclusion： MRI plays an important role in the demonstration of pathological and hemodynamic characteristics of FNH. DWI could provide additional valuable information for the imaging diagnosis of FNH.