肝脏局灶性结节增生的不典型常规MRI影像表现  

Atypical MRI appearance of hepatic focal nodular hyperplasia

作　　者：唐艳华[1] 张峰[1] 王海屹[1] 康素海[1] 张晓晶[1] 王叶[1] 李杰[2] 叶慧义[1] 

机构地区：[1]解放军总医院放射诊断科,北京100853 [2]解放军总医院病理科,北京100853

出　　处：《中华医学杂志》2016年第7期544-546,共3页National Medical Journal of China

基　　金：首都发展科研专项基金（2011-5001-05）

摘　　要：目的探讨肝脏局灶性结节增生（FNH）的不典型常规MRI影像学特征，提高该病的影像诊断能力。方法回顾性分析2012年1月至2015年6月来解放军总医院放射科磁共振室做肝脏MRI检查患者影像，不符合FNH典型常规MRI表现，且经病理证实为FNH者共13例（男10例、女3例），分析其影像特征。结果12例（22个）局灶性病灶，1例弥漫性病灶。局灶性病灶：3个有脂肪变性；1个有出血；7个有假包膜。动态增强扫描：12／22个渐进性持续强化；20／22个病灶做特异性对比剂，均摄取对比剂。弥漫性病灶：女性，有明显脂肪变性，均摄取肝脏特异性对比剂。结论FNH不典型影像表现主要发生在中年男性患者，可表现有脂肪变性，出血，假包膜，增强方式多样，肝细胞特异性对比剂检查可帮助其诊断。Objective To explore the atypical MRI findings of focal nodular hyperplasia （FNH） of the liver. Methods Retrospective analyses were conducted for 13 cases （10 males and 3 females） confirmed pathologically as FNH after surgery or biopsy with liver MRI examination from January 2012 to June 2015 in PLA General Hospital. Results There were 22 focal lesions in 12 eases, and diffuse pattern in 1 case. In the 22 focal lesions, there were 3 lesions with fatty change, 1 lesion with hemorrhage, 7 lesions with pseudo-capsule, regarding to dynamic contrast-enhanced pattern： 12/22 lesions with gradually increasing enhancement, 3/22 lesions with rapid wash-in and wash-out, and 7/22 lesions with rapid wash-in and slow wash-out. The hepatocyte-specific agent examinations were performed in 20/22 lesions, and 20/20 lesions showed iso- to hyper-intensity to the liver parenchyma in the hepatocyte phase. There was 1 case （female） showing diffuse lesions with obvious fatty change, and all the lesions took up the hepatocyte-specific agent in hepatocyte phase. Conclusion The atypical focal nodular hyperplasia often occurs in middle age males and could demonstrate fatty change, hemorrhage, pseudo-capsule, various enhancement patterns. And when the FNH showed atypical routine MRI findings, the use of the hepatocyte-specific agent could facilitate the diagnosis.

关 键 词：磁共振成像 肝疾病 增生 

分 类 号：R575[医药卫生—消化系统] R445.2[医药卫生—内科学]