肝脏局灶性结节性增生和甲胎蛋白阴性肝细胞癌患者的影像学特点分析

Patients with liver FNH and HCC patients with negative AFP: plain and dynamic enhanced MRI and CT findings

目的：探讨肝脏局灶性结节性增生（FNH）和甲胎蛋白（AFP）阴性肝细胞癌（HCC）患者的 MRI 和 CT 平扫及动态增强表现。方法回顾性分析2012年4月－2014年4月北京市密云县医院收治的124例肝脏肿瘤患者的临床资料。结果74例 FNH患者中，54例患者接受 CT 检查，其中38例患者接受三期动态增强扫描，16例患者仅接受平扫；62例患者接受 MRI 检查，均接受平扫及增强扫描，其中应用钆贝葡胺（Gd －BOPTA）造影剂42例。50例 AFP 阴性 HCC 患者中，40例患者接受 CT 检查，其中10例患者只接受平扫；46例患者接受 MRI 平扫及增强扫描，其中采用 Gd －BOPTA 造影剂30例，30例30个病灶中延迟1～2 h 扫描均呈低信号。结论FNH 和 AFP 阴性 HCC 患者的 MRI 和 CT 平扫及动态增强表现各具特点，多种检查方法联合应用能够促进二者诊断率的显著提升。

Objective To investigate plain and dynamic enhanced magnetic resonance imaging （MRI）and computed tomography （CT） findings in patients with focal nodular hyperplasia （FNH）of the liver and hepatocellular carcinoma （HCC）patients with negative alpha -fe-toprotein （AFP）.Methods A statistical analysis was performed on the clinical data of 124 cases of liver tumor admitted to Beijing Miyun County Hospital from April 2012 to April 2014.Results Fifty -five of the 74 patients with FNH underwent CT examination,among whom 38 patients received three -phase dynamic enhanced scan and 16 received only plain scan;62 cases had plain and enhanced MRI with the application of contrast agent Gd -BOPTA in 42 patients.Among the 50 HCC patients with negative AFP,CT examination was performed in 40 and 10 only had plain scan;46 patients received plain and enhanced MRI with the use of contrast agent Gd -BOPTA in 30.Delayed scan after 1 -2 h demonstrated low signal in 30 lesions of the 30 cases.Conclusion For patients with liver FNH and AFP -negative HCC pa-tients,their plain and dynamic enhanced MRI and CT scan have respective characteristics.A combination of multiple examination methods can significantly improve diagnostic yield of the two diseases.