儿童肝脏局灶性结节增生临床表现与影像学表现关联分析  

Analysis of clinical and imaging manifestations of hepatic focal nodular hyperplasia in children

作　　者：侯志彬[1] 王春祥[1] 李欣[1] 

机构地区：[1]天津市儿童医院影像科,天津300401

出　　处：《放射学实践》2016年第5期429-433,共5页Radiologic Practice

摘　　要：目的：探讨儿童肝脏局灶性结节增生（FNH）的影像表现,提高对该病影像学特征的认识。方法：回顾性分析6例经病理证实为FNH的患儿临床及影像学资料,其中3例患儿发病前确诊患有神经母细胞瘤、急性淋巴细胞白血病和髓母细胞瘤,另外3例患儿无恶性病变病史,均系偶然发现。3例患儿行MRI检查,2例患儿行CT检查,1例患者行CT及MRI检查,行CT检查者全部行增强扫描,2例行MRI增强扫描。结果：6例诊断为FNH患儿中3例（男2例,女1例,平均年龄8.7岁）存在远隔脏器恶性病变病史,影像学上3例患儿肝脏均呈多发病变,病变最大径2.0~5.2cm,边界尚清楚,1例可见纤维分隔及中心瘢痕,1例可见引流静脉。其他3例FNH患儿（男1例,女2例,平均年龄7.3岁）无恶性病变病史,2例呈单发病变,1例呈多发病变;病变最大径4.3~7.6cm,边界清楚,2例可见纤维分隔及中心瘢痕,3例均无明确引流静脉显示。结论：增强CT及MRI检查,尤其是MSCT血管成像能真实反映儿童FNH的病理学特点及血液动力学改变,对儿童肝脏FNH患者影像学特点的认知和了解对于该病的鉴别诊断及临床治疗具有重要意义。Objective：To analyze the clinical and imaging manifestations of focal nodular hyperplasia（FNH）in children,and to improve the knowledge of imaging characteristics of FNH.Methods：The clinical and imaging materials of 6pediatric patients with pathology proved FNH were retrospectively analyzed.Three patients had the histroy of neuroblastoma,acute lymphoblastic leukemia and medulloblastoma respectively,the other three patients had no history of malignacy.All FNH lesions were revealed by chance.Three patients had MRI,2patients had enhanced MSCT,and one had both MRI and enhanced CT,2patients had enhanced MRI.Results：Of the six patients with FNH,3patients（male,2patients;female,1patient;average age,8.7y）had a history of malignancy.They had multiple liver lesions,with the largest dimension as 2.0~5.2cm,well defined,with fibrous septa and central scar in 1patient and draining vein in 1patient.In the remaining three patients（male,1patient;female,2patients;average age,7.3y）had no history of malignancy,showing solitary lesion（2patients）and multiple lesions（1patient）.The largest dimension was 4.3~7.6cm,with fibrous septa and central scar in 2patients,no draining vein was assessed in all 3patients.Conclusion：Enhanced CT and MRI,especially MSCTA can clearly show the pathologic characteristics and hemodynamic change of FNH in children,which is significant in the understanding of imaging characteristics and helpful in the differential diagnosis as well as clinical treatment.

关 键 词：局灶性结节增生 肝脏 儿童 体层摄影术 X线计算机 磁共振成像 

分 类 号：R725.7[医药卫生—儿科] R816.92[医药卫生—临床医学]