肝局灶性结节增生的CT影像特点与鉴别诊断

CT imaging features and differential diagnosis of hepatic focal nodular hyperplasia

目的探讨肝局灶性结节增生(FNH)的CT影像学表现与鉴别诊断。方法回顾性分析21例经病理证实的FNH的三期螺旋CT影像表现。结果 20例为单发病灶,1例为2个病灶。平扫病灶均表现为低密度或略低密度,15个病灶密度欠均匀,中央区可见星芒状更低密度区;动态增强扫描:动脉期表现为明显异常强化(16个)、中等度异常强化(5个),中央星状瘢痕均无异常强化,其中病灶中央或周边见迂曲血管7例,门脉期、延迟期病灶密度有所减低,中央星状瘢痕延迟期均有强化。结论 FNH有特征性的CT影像学表现,对其正确诊断有助于拟定正确的治疗方案并避免创伤。

Objective To investigate the CT imaging manifestations and differential diagnosis of hepatic focal nodular hyperplasia （FNH）. Methods The three phrase spiral CT imaging manifestations of 21 patients with FNH confirmed by pathology were analyzed retrospectively. Results 20 patients had single lesion and 1 patient had 2 lesions.Plain scan showed low density or slightly low density in all lesions,15 lesions with uneven density and a stellate lower density area in the central area.Dynamic enhanced scan showed significant abnormal enhancement （16 cases）,moderate abnor- mal enhancement （5 cases） and no abnormal enhancement in the central stellate scar in the arterial phase,among them, 7 cases of circuitous blood vessels were seen in the central or peripheral lesions;the density of lesions reduced in the portal venous stage and delay stage and the central stellate scar enhanced in the delay stage. Conclusion FNH has characteristic CT imaging manifestations and the right diagnosis is conducive to developing the right treatment regimen and avoiding trauma.