无瘢痕的FNH与肝腺瘤的CT鉴别诊断

CT Differential Diagnosis of Scarless-FNH and Hepatic Adenoma

目的探讨无瘢痕的局灶性结节增生(FNH)与肝腺瘤(HCA)的影像学差异及鉴别要点。方法对比分析17个无瘢痕影像的FNH病灶与12个HCA病灶的影像表现,定量分析两组病灶各期的CT值及CT强化值。结果 82.4%的无瘢痕FNH<3 cm,91.7%的HCA>3 cm。在门静脉期无瘢痕FNH多呈进一步强化(76.5%),而HCA组强化保持不变相对较多见(41.7%)。23.5%的无瘢痕FNH可见"中心开花式"强化,HCA组未见此征象。两组病灶间各个期相的CT值差异无统计学意义(P>0.05),无瘢痕FNH组平衡期的CT强化值稍低于HCA组(P<0.05)。结论无瘢痕FNH体积小,坏死、脂肪变性、钙化等出现率低,"中心开花式"强化有助于FNH的诊断。

Objective To retrospectively analyze the CT imaging features of scarless focal nodular hyperplasia(FNH)and hepatocellular adenoma(HCA),and to explore the main points of differential diagnosis between the two lesions.Methods 17 lesions of FNH,which did not show obvious scar,and 12 lesions of HCA were selected.We analyzed the imaging findings and the difference between the two lesions on CT Images.We measured and quantitatively analyzed the CT value and the CT enhancement value of each phase,find the differences between the two groups of lesions by statistical analyses.Results 82.4%of the scarless-FNH lesions were smaller than 3 cm,while 91.7%of the HCA lesions were larger than 3 cm.Most of the scarless-FNHs showed a further enhancement in Portal phase(76.5%),while HCAs are more likely to be remained unchanged(41.7%).4 cases of scarless-FNHs(23.5%)showed a'central flowering'enhancement,while none of the HCAs showed this sign.There was no statistical difference in the CT value of each phase between the two groups(P>0.05).In the equilibrium phase,the CT enhancement value of scarless-FNH group was lower than that of HCA group(P<0.05).Conclusion Scarless-FNH was smaller than HCA,and the occurrence rate of necrosis,fatty degeneration and calcification was also lower.'Central flowering|'enhancement was helpful for the diagnosis of FNH.