肝脏局灶性结节增生的临床诊治分析

Diagnosis and treatment of focal nodular hyperplasia of liver

目的探讨肝局灶性增生结节（FNH）的临床诊断与治疗。方法回顾性分析2006年1月至2011年7月收治的26例FNH病例的临床资料。结果26例中CT检查19例、其中平扫5例。结果14例呈低密度，5例呈等密度，10例病灶中央可见不规则低密度影，动脉期全部病灶均明显均匀强化。8例可见增粗的供血动脉，门脉期病灶密度有所下降，但仍高于肝实质，延迟期病灶呈等密度或略低于肝实质，7例中央瘢痕延迟强化。患者手术治疗22例，行左半肝4例、左外叶5例、肝部分切除13例。病理诊断为FNH，大多肿瘤质软，肉眼剖面呈较肝脏颜色略浅的棕色或黄褐色，部分病例可见中央瘢痕和放射状纤维间隔随访4个月-5年，未见复发。随诊观察4例，随访2-4年，未见增长。结论增强CT、MRI检查是FNH重要的诊断方法，手术切除是有效的治疗手段。

Objective To explore the diagnosis and treatment of focal nodular hyperplasia （FNH） of liver. Methods The clinical data were retrospectively analyzed for 26 cases with confirmed FNH of liver from January 2006 to July 2011. Enhanced computed tomography and magnetic resonance imaging were performed. Results Among them, 22 cases underwent surgical resection, including left hemihepatectomy （ n -- 4 ）, left lateral lobe hepatectomy （ n --- 5 ） and partial hepatectomy （ n = 13 ）. The pathological diagnosis was FNH. Most tumors were of soft texture. The gross surface was brown or yellow-brown in color. Central scar and radiating fibrous septas were spotted in some cases. There was no recurrence during a follow-up period of 4 months to 5 years. Serial observations were conducted for 4 cases with a follow-up period of 2 - 4 years. No growth was observed. Conclusions Enhanced CT and MRI are important diagnostic tools. The confirmed cases may be followed up. Surgical resection is effective with an excellent prognosis.