肝局灶性结节增生的CT和MRI表现与病理对照分析  

Pre-and Post-contrast Multiphase Helical CT and Pathological Analysis of An Compatine Analysis of MSCT and MRI with pathotogy of

作　　者：贾建明[1] 李华灿[1] 张玉琴[1] 陈自谦[2] 

机构地区：[1]福建中医药大学附属第二人民医院影像科,350003 [2]福州南京军区福州总医院影像科

出　　处：《中国CT和MRI杂志》2010年第5期40-44,共5页Chinese Journal of CT and MRI

摘　　要：目的分析肝脏局灶性结节增生(FNH)的平扫和多期增强扫描的CT和MRI表现,提高其诊断的准确率。方法回顾性分析18例(21个病灶)经病理证实的FNH的CT,和6例MRI表现。结果 CT平扫显示21个病灶中呈均匀低密度7个,呈不均匀低密度14个。增强扫描动脉期除中央疤痕外,明显均匀增强19个,中等度不均匀增强1个,轻度不均匀增强1个,病灶中心或周边增粗、扭曲的动脉6个;门脉期和延迟期扫描显示呈略高密度10个,呈等密度6个,呈略低密度5个。平扫显示伴中央星状疤痕者7个,多期增强CT显示中央疤痕并于平衡期出现延迟增强15个病灶。MRI检查6例均呈不均匀略长或等T1,及略长或等T2信号,增强动脉期呈明显增强,在门脉期及延迟期呈等强化或强于肝实质。4个在平扫MRI上显示中央瘢痕并有延迟增强。结论 CT平扫和动态增强扫描能较全面显示FNH的病理特征和血供特点,明显地提高与其他富血管恶性肿瘤的鉴别诊断能力。FNH具有典型的MRI表现,平扫T1WI呈等或稍低信号,T2WI呈等或稍高信号,增强扫描动脉期呈明显均匀强化.在门脉期和延迟期呈等或稍高信号;病灶内可见特征性中心瘢痕T1WI低信号,T2WI高信号,增强扫描延迟期出现强化。对不典型FNH应结合病史,必要时穿刺活检。Objective To analyze the CT and MRI findings of hepatic focal nodular hyperplasia（FNH）,and to improve diagnosis accuracy of FNH.Methods The MSCT and MRI（6cases） findings were analyzed retrospectively in 18 patients（total 21 lesions） with FNH,which were approved surgically and pathologically.Results On plain CT scans,of 21 FNH lesions,lesions were homogeneous hypodense and14 lesions were inter-homogeneous hypodense.In the arterial phase,19 lesions were vigorously and homogeneously enhanced,1 lesions was much inter-homogeneously enhanced,and 1 lesions was slight and inter-homogeneously enhanced,except the central scar.Tortuous and dilated arteries were seen at the center or peripheral area in 6 of 21 lesions.In the portal venous phase and delayed phase,10 lesions remained slightly hyperdense,6 lesions turned to isodense,and 5 lesions turned to slightly hypodense.Central scar was found in 7 lesions on unenhanced images and on dynamic contrast-enhanced images,15 lesions demonstrated late enhancement.MR images of 6 patients always showed appearance with slightly low intensity signal in T1-weighted images and isointensity or slightly hyper intensity signal in T2-weighted images.All lesions with markedly enhanced on the arterial phase and prolonged enhanced in the portal venous phase and delayed phase.Central scar was found in 4 lesions which demonstrated late enhancement.Conclusion MSCT and MRI scanning can fully show the pathologic and the blood supplying characteristics of FNH and improve to differentiate ability from other malignant hypervascular tumors.

关 键 词：局灶性结节增生 肝脏 多期扫描 螺旋CT磁共振成像 

分 类 号：R814.4[医药卫生—影像医学与核医学] R445.2[医药卫生—放射医学]