儿童肝脏局灶性结节增生MSCT表现(附18例报告)

MSCT features of hepatic focal nodular hyperplasia in Children (report of 18 cases)

目的:探讨儿童肝脏局灶性结节增生(FNH)的MSCT表现与病理特征,以提高该病的诊断准确率。方法:搜集经病理证实18例FNH共22个病灶,术前均行CT平扫及三期增强扫描,分析病灶影像学特点并与病理对照。结果:18例患儿中5岁以下7例,5岁以上11例;16例患儿为单发,2例多发,肝内各见3个病灶;22个病灶中瘤体最长径约2.0~18.1 cm,边界清楚,形态较规则,以类圆形为主,21个病灶未见包膜,1个病灶见假包膜;CT平扫1个高密度,9个等密度,12个低密度;增强扫描动脉期20个病灶明显均匀强化,1个病灶轻度强化,1个不均匀强化;门脉期16个病灶呈等密度,6个呈高密度;延迟期21个病灶呈等密度,1例呈高密度;10个病灶见中央疤痕,延迟期疤痕均见强化。结论:儿童FNH的CT表现较有特点及一致性,多期增强扫描可充分反映病灶的血供特点、病理变化,结合病理和影像特点可提高该病的认识及诊断,有助于临床制定治疗方案。

Objective:To investigate the MSCT manifestations and pathological features of hepatic focal nodular hyperplasia(FNH)in children,so as to improve the accuracy of diagnosis.Methods:Eighteen patients with FNH,which were confirmed by pathology,were analyzed retrospectively.Totally 18 patients with 22 lesions were enrolled.Plain and three phases pos-contrast CT were performed on all patients before operation.The CT imaging features were analyzed and compared with pathology.Results:Among the patients,7 patients were under 5 years old,11 patients were over 5 years old.16 cases had single lesion,2 cases had multiple lesions,which had 3 lesions in liver.Among 22 lesions,the largest dimension were 2.0~18.1cm,well defined,most of them were round,and 1 case with pseudo-capsule.On plain CT,1 lesion was hyper-density,9 lesions were iso-density,12 lesions were hypo-density;In arterial phase,20 lesions were significantly enhanced,1 lesion was mild enhanced,and one showed significantly heterogeneous enhancement.In portal venous phase,16 lesions were iso-density,6 lesions were hyper-density.In delayed phase,21 lesions were iso-density and 1 lesion was hyper-density.10 lesions with central scar showed delayed enhancement.Conclusion:The CT features of FNH in children are distinctive to some extent.Enhanced CT feature can reflect the characteristics of blood supply,which were related with pathological findings.Combining with pathological findings and CT features can improve the understanding and diagnosis of the disease,and be helpful for the treatment.