MSCT和MRI对肝脏局灶性结节增生的诊断价值  

Multi-slice CT and MRI in the Diagnosis of Hepatic Focal Nodular Hyperplasia

作　　者：殷小平[1,2] 李彩英[1,2] 冯平勇[1,2] 杨雪[1,2] 封海龙[1,2] 刘怀军[1,2] 

机构地区：[1]河北医科大学第二医院影像科,石家庄050000 [2]河北大学附属医院CT,MRI室,河北070000

出　　处：《放射学实践》2009年第4期400-404,共5页Radiologic Practice

摘　　要：目的:探讨肝脏局灶性结节增生(FNH)CT和MRI表现及其诊断价值。方法:回顾性分析11例FNH患者的影像学表现。所有患者均行16层螺旋CT及MRI平扫和动态增强扫描检查。结果:CT平扫显示病灶均呈稍低密度灶,1例在脂肪肝背景下呈相对高密度。增强扫描动脉期示病灶均呈明显均匀强化,2例可见扭曲扩张的供血动脉,8例病灶中央可见瘢痕区无明显强化;门静脉期及延时期示病灶稍高于、等于或低于周围肝实质,中心瘢痕灶延时期强化。MRI检查示病变呈等信号或稍低T1信号及稍高T2信号,增强扫描动脉期示病灶明显强化,门脉期和延时期呈稍高信号或等信号,11例显示病灶中央疤痕呈延迟强化。1例行MRS检查提示Cho峰明显升高。4例行DWI检查,病灶呈等信号或稍高信号,ADC图上呈等信号或稍低信号。结论:MRI较CT能更全面地显示FNH的病理特征,DWI和MRS检查有重要辅助诊断价值。Objective：To study the CT and MRI manifestations and their value in the diagnosis of hepatic focal nodular hyperplasia （FNH）. Methods：The CT and MRI findings of FNH in 11 patients were analyzed retrospectively. All patients underwent 16-detector row spiral CT and MR scanning with and without contrast enhancement. Results：On plain CT, all lesions showed slightly low density,one patient had fatty liver background,the FNH lesion showed relatively high density. With contrast administration, the lesions showed intense and homogeneous enhancement during arterial phase, except for 8 lesions with the central scar which didn＇t show obvious enhancement. Tortuous and dilated arteries were detected in 2 lesions. During portal vein phase and delayed phase,lesions remained slightly hyper-/ iso-/ hypo attenuated when compared with the surrounding liver parenchyma. The central scar demonstrated delayed enhancement. On MR imaging,all 11 lesions showed slightly hypo-or iso intensity on T1 WI and slightly hyper-intensity on T2 WI. After contrast administration,lesions showed marked enchaneement on arterial phase,slightly hyper-intensity or iso-intensity on portal as well as delayed phase. Central scars showed delayed enhancement in all of the 11 lesions. 1 patient had MR spectroscopy,showing marked increase of Cho peak. 4 patients had diffuse weighted imaging,showing slightly hyper intensity or iso-intensity of the lesions. Iso / slightly hypo signal intensity were shown on ADC images. Conclusion： MRI displays the pathologic characteristics of FNH better than CT,DWI and MRS provide important supplementary information for the diagnosis.

关 键 词：局灶性结节增生 肝脏 体层摄影术 X线计算机 磁共振成像 

分 类 号：R575[医药卫生—消化系统] R445[医药卫生—内科学]