CT双期增强扫描在肝脏FNH和肝腺瘤中的诊断价值

Value of Dual-phasic Enhanced CT Scan in the Diagnosis of Liver Focal Nodular Hyperplasia and Hepatocellular Adenoma

【目的】探讨多排螺旋CT双期增强扫描在肝脏局灶性结节状增生（focalnodularhyperplasia，FNH）和肝腺瘤中的诊断价值。【方法】回顾性分析经病理确诊为FNH患者20例（22个病灶）和肝腺瘤患者15例（17个病灶）的CT影像学特征，包括病灶大小、形态、数目、部位、强化特点及强化值。【结果】FNH病灶中，有2例（10％）为多发，18例为单发，11个病灶位于肝左叶，9个病灶位于肝右叶，2个位于尾状叶；肝腺瘤中有2例为多发（13．3％），13例为单发，9个位于肝左叶，7个位于肝右叶，1个位于尾状叶。FNH中40．9％（9／22）可见星芒状瘢痕，31．8％（7／22）可见增粗的供血动脉；肝腺瘤中17．6％（3／17）中央可见缺血坏死，17．6％（3／17）内见出血灶，29．4％（5／17）可见包膜。FNH动脉期CT强化值为（65．6±15．9）HU，显著高于肝腺瘤（41±21．2）HU。【结论IFNH和肝腺瘤在CT表现上具有许多相似性，CT双期增强扫描量化指标能提供更多的的鉴别信息。

[Objective] To explore the value of dual-phasic multi-slice helical enhanced CT scan in the diagnosis of liver focal nodular hyperplasia（FNH） and hepatocellular adenoma（HCA）. [Methods] CT imaging features（size, shape, number, location, enhancement characteristics and value） of 20 FNH patients（22 lesions） and 15 HCA patients（17 lesions） confirmed by pathology were analyzed retrospectively. [Results] Among FNH patients, 2 patients（10%） were multiple and 18 patients were single. Eleven FNH lesions located left lobe of liver, and 9 lesions located right lobe of liver, and 2 lesions located caudate lobe. Among HCA patients, 2 patients（13.3%） were multiple and 13 patients were single. Nine HCA lesions located left lobe of liver, and 7 lesions located right lobe of liver, and one lesion located caudate lobe. Star-aristiform scar was seen in 40.9%（9/22） of FNH, and thickened bloodTsupply artery was seen in 31.8% （7/22） of FNH. Central ischemic necrosis was seen in 17.6% （3/17） of HCA, and hemorrhagic focus was seen in 17.6% （3/17） of HCA, and enveloped membrane was seen in 29.4% （5/17） of HCA. CT enhancement value of FNH at arterial phase was （65.6± 15.9）HU, which was significantly higher than that of HCA[（41±21.2）HU]. [Conclusion] CT findings of FNH and HCA have similarity. The parameters of dual-phasic multi-slice enhanced CT scan can provide more differential information.