肝脏局限性结节状增生的多排螺旋CT及MRI表现与病理对照分析  

Analysis of MSCT and MRI manifestations of liver focal nodular hyperplasia comparing with pathological results

作　　者：马振波[1] 姜正岳 朱莉[3] 张娟[4] 苏慧[1] 张立涛[1] 刘志强[1] 孔雪[1] 谢元忠[1] 

机构地区：[1]泰安市中心医院医学影像部,山东省271000 [2]肥城市中医院影像科,山东省271600 [3]泰山医学院附属医院输血科,山东泰安271000 [4]泰山医学院附属医院影像科,山东泰安271000

出　　处：《中华消化病与影像杂志（电子版）》2015年第2期9-12,共4页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的通过分析肝脏局限性结节状增生(FNH)的多排螺旋CT(MSCT)及MRI表现与相应的病理改变,探讨MSCT及MRI对FNH的诊断价值。方法回顾性分析泰安市中心医院及泰山医学院附属医院22例24个经手术或穿刺活检病理证实FNH的MSCT和MRI表现特点,并与病理对照。MSCT检查13例,MRI检查9例,在22例中有4例既行MSCT检查又行MRI检查。结果 (1)MSCT及MRI平扫:MSCT检出14个病灶,平扫病灶均呈均匀或不均匀的等或稍低密度改变,9例病灶见低密度中央瘢痕,呈裂隙状、星芒状改变。MRI检出10个病灶,呈等或稍长T1、T2信号,7例病灶见中央瘢痕。DWI显示10例,其中高信号1例,略高信号9例。(2)MSCT及MRI增强扫描:MSCT增强扫描,动脉期除中央瘢痕外,病灶均明显增强,6个病灶内或周边见扭曲、增粗的供血动脉。门脉期病灶呈稍高密度,延时期12个病灶呈等或稍高密度,2个病灶呈稍低密度,9个病灶的中央瘢痕均延时增强。MRI增强动脉期病灶增强明显,门脉期及延时期呈等或稍高信号,6个病灶中央瘢痕延时增强。结论 MSCT和MRI平扫及三期动态增强扫描能准确显示FNH的病理改变及血流动力学特征,MRI较MSCT略有优势,二者相结合在FNH的诊断及鉴别诊断中具有较高临床价值。Objective To analyze the features of multislice spiral computed tomography（ MSCT） and MRI in liver focal nodular hyperplasia（ FNH） comparing with pathological results,and to explore the value of MSCT and MRI in the diagnosis of FNH.Methods The MSCT and MRI findings of 22 patients（24 lesions） pathologically confirmed FNH were retrospectively studied and compared with pathological features.Thirteen patients were examined by MSCT,9 patients by MRI,and 4 patients by both MSCT and MRI.Results （1） Pre-contrast MSCT and MRI：MSCT found 14 lesions.On pre-contrast MSCT,the lesions showed homogeneous or heterogeneous and equi-density or hypo-density changes.There was a slit-like,stellate-shaped low density central scar in 9 lesions.MRI found 10 lesions,which showed slightly long or iso-T1 and T2 signal intensity. A central scar was seen in 7 lesions.DWI found 10 lesions,including 1 case with high signal and 9 cases with slightly high signal.（ 2 ） Post-contrast MSCT and MRI：The lesions showed intense and homogeneous enhancement during arterial phase, except for the central scar on post-contrast MSCT.Dilated and tortuous arteries were erected around 6 lesions.The lesions showed moderate hyper-density during the portal vein phase.Twelve lesions remained mild hyper-density or iso-density and 2 lesions showed mild hypo-density during the delayed phase.Nine lesions with central scars demonstrated delayed enhancement.On post-contrast MRI imaging, the lesions demonstrated intense arterial enhancement and moderate portal and delay enhancement.Six lesions with central scar showed delayed enhancement.Conclusions MSCT and MRI using plain and dynamic enhanced scans can show accurately the pathological features and the characteristics of blood supply of FNH.MRI is slightly better compared with MSCT.A combined use of both MSCT and MRI has a great value in the diagnosis of FNH.

关 键 词：局限性结节状增生 磁共振成像 体层摄影术 螺旋计算机 病理学 

分 类 号：R735.7[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2