肝脏局灶性结节增生的临床诊治(附22例报道)  

Diagnosis and treatment of hepatic focal nodular hyperplasia(Analysis of 22 cases)

作　　者：高鹏骥[1] 陈雷[1] 高杰[1] 王东[1] 黄磊[1] 李澍[1] 王福顺[1] 冷希圣[1] 朱继业[1] 

机构地区：[1]北京大学人民医院肝胆外科,肝硬化肝癌基础研究北京市重点实验室,北京100044

出　　处：《中国普外基础与临床杂志》2017年第5期546-550,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：北京大学人民医院研究与发展基金资助项目(编号:RDC2015-01)

摘　　要：目的总结肝脏局灶性结节增生的临床表现、影像学特点及治疗方法。方法从北京大学人民医院病案数据库中检索2007年1月至2016年12月期间接受肝脏手术患者的临床病理资料,选取经病理证实存在肝脏局灶性结节增生的病例进行回顾性分析,分析肝脏局灶性结节增生患者的临床特点及各种影像学检查方法的正确诊断率。结果共有22例经病理检查证实为肝脏局灶性结节增生的患者纳入了本研究,其中男10例,女12例。年龄20~61岁,(36.8±11.2)岁,>50岁者有3例。18例患者为体检时发现,3例因右上腹胀痛就诊,1例因甲胎蛋白轻度升高检查发现。3例患者在观察过程中出现病灶明显增大。17例患者做了腹部增强CT,准确诊断为肝脏局灶性结节增生者11例(64.70%);19例做了MRI检查,准确诊断为肝脏局灶性结节增生者16例(84.21%)。2例病灶位于肝脏尾叶,9例位于左肝,11例位于右肝。病灶最大径线为1.0~7.8 cm,(4.16±1.92)cm,最大径线>5.0 cm者有9例。所有患者在接受肝部分切除手术治疗后均顺利恢复,未出现严重并发症。随访1~103个月,未见肝脏局灶性结节增生复发。结论肝脏局灶性结节增生多见于年轻患者,常为体检时发现,MRI扫描具有较好的诊断价值。Objective To summarize manifestation, imaging characteristics, and treatment of hepatic focal nodular hyperplasia （FNH）. Methods From January 2007 to December 2016, the patients pathologically confirmed hepatic FNH were included in this study. The clinical features and imaging characteristics were analyzed retrospectively. Results Twenty-two cases were pathologically diagnosed as hepatic FNH with an age of （36.8± 11.2） years （range from 20 to 61 years）. Ten were males and 12 were females. Three patients had abdominal pain and 19 patients had no symptoms, The diameter of the lesions was （4.16±1.92） cm （range from 1.0 to 7.8 cm） and approximately 9 （40.9%） lesions were more than 5.0 cm. The diagnosis rates of CT and MRI were 64.70% （11/17） and 84.21% （16/19）, respectively. All the patients underwent hepatectomy successfully and recovered without severe complications. No recurrence and metastasis happened during following-up of 1-103 months. Conclusions Hepatic FNH is more common in young patients and has no typical symptoms. MRI is useful in diagnosis of hepatic FNH.

关 键 词：局灶性结节性增生 磁共振成像 诊断 治疗 

分 类 号：R735.7[医药卫生—肿瘤]