肝脏局灶性结节增生的CT/MRI表现及病理分析  

CT/MRI Findings and Pathologic Correlation of Hepatic Focal Nodular Hyperplasia

作　　者：钟志伟[1] 陈淮[1] 何建勋[1] 

机构地区：[1]广州医科大学附属第一医院放射科,广东广州510120

出　　处：《中国CT和MRI杂志》2015年第5期84-86,110,共4页Chinese Journal of CT and MRI

摘　　要：目的评价CT及MRI检查对肝脏局灶性结节增生的临床诊断价值。方法回顾性分析10例经病理最终确诊为肝脏局灶性结节增生的患者,分析其CT及MRI影像资料,并与病理进行对照研究。结果其中6例患者行CT扫描,4例患者进行MRI扫描,所有患者均进行增强检查。共观察到病灶10个,病灶位于肝脏左外叶1个,左内叶3个,右前叶3个,右后叶3个,最大平面直径范围为(1.9-4.3cm),平均3.0±1.2cm。CT病灶6个,平扫呈等密度2个,低密度4个,低密度病灶1例边界清楚,3例病灶边界显示模糊,其中可见更低密度疤痕组织3例。CT增强动脉期显示6例病灶均呈明显强化,中间疤痕组织无强化,6例病灶边界均显示清晰,未见明显包膜;门脉期病灶较动脉期密度降低,但仍较肝脏组织密度高,中间疤痕仍呈低密度;延迟期病灶呈等密度为主,疤痕组织可见强化。MRI检出4个病灶,病灶T1WI呈稍低信号,T2WI呈稍高信号,2例可见中央疤痕,疤痕组织在T1WI上呈低信号,T2WI上呈明显高信号,增强动脉期明显强化,门脉期及延时期呈稍高或等信号,中央疤痕均可见延时强化。结论肝脏局灶性结节增生的CT及MRI影像征象有一定特征性,在诊断及鉴别诊断中有很好的作用,但最终确诊还需要病理证实。Objective We used CT and MRI to observe of hepatic focal nodular hyperplasia, and to improve its diagnostic accuracy with CT and MRI.Methods Pathological confirmed of hepatic focal nodular hyperplasia in 10 cases, reviewed the CT and MRI imaging,and to correlation with pathological.Results 6 cases have live CT scan,4 cases have live MRI scan, all the patients have enhanced.10 lesions were observed. 1 lesions located in left lateral lobe, 3 in left inner lobe, 3 in right anterior lobe, 3 in right posterior lobe. The average diameter is 3.0±1.2cm, range（1.9-4.3cm）.6 lesions of CT scan, pre-contrast： 4 of 6 lesions were hypodense, 3 lesions were isodense, 1 lesions have smooth edge, 3 lesions have central scar area. On the arterial phase scans, all lesions were markedly and homogeneously enhanced; On portal venous phase： all of the lesions turned to slightly hyperdense, the central scar area were still hypodense. On delayed phase： the lesions turned to isodense, and the central scar area demonstrated late enhancement. 4 lesions showed slightly low signal in T1-weighted images and isointensity or slightly high intensity in T2-weighted images. All lesions had apparent enhancement in the arterial phase and prolonged enhanced in the portal venous phase and delayed phase. Central scar was found in 2 lesions and demonstrated late enhancement.Conclusion High sensitivity of observations imaging findings of hepatic focal nodular hyperplasia by using CT and MRI. it is of great value in diagnosing and differentiating FNH, and the last confirmed diagnostic need pathological.

关 键 词：局灶性结节增生 肝脏 CT 病理 

分 类 号：R735.7[医药卫生—肿瘤] R445.3[医药卫生—临床医学]