肿瘤化疗患者肝局灶性结节性增生样病变的影像学特征  

Imaging features of focal nodular hyperplasia-like lesions in the liver of patients undergoing antineoplastic chemotherapy

作　　者：殷亮 甘洁 李章柱 商明艳 李宗昌 YIN Liang;GAN Jie;LI Zhangzhu;SHANG Mingyan;LI Zongchang(Imaging Center,Shandong Provincial Third Hospital,Ji'nan 250030,China)

机构地区：[1]山东省立第三医院影像中心,山东济南250030

出　　处：《实用放射学杂志》2024年第3期390-393,共4页Journal of Practical Radiology

基　　金：山东省立第三医院杰出青年人才项目(jqrc007)。

摘　　要：目的探讨肿瘤化疗患者肝局灶性结节性增生样(FNH-like)病变的影像表现及发病机制.方法回顾性分析普通肝脏局灶性结节性增生(FNH)和肿瘤化疗后经病理证实FNH-like患者的临床及影像资料.结果15例肿瘤化疗后FNH-like患者中,检出肝脏多发FNH结节8例,单发结节7例,共检出结节67个.FNH-like结节的平均发现时间(18.9±11.7)月.67个结节中有5个结节在复查时可以观察到中央瘢痕,其余均表现为非经典型FNH特点.45个结节行肝细胞特异性对比剂检查,36个结节表现为肝胆期稍高信号,9个结节表现为等信号.结论肿瘤患者在化疗期间出现FNH-like病变具有一定的影像学特征,如缺乏中央瘢痕、结节多较小、延迟强化、肝胆特异期高强化等,对该病的诊断及鉴别诊断有重要价值.Objective To investigate the imaging manifestations and pathogenesis of liver focal nodular hyperplasia-like(FNH-like)lesions in patients undergoing antineoplastic chemotherapy.Methods The clinical and imaging data of focal nodular hyperplasia(FNH)and FNH-like lesions patients confirmed by pathology after antineoplastic chemotherapy were analyzed retrospectively.Results A total of 67 FNH-like nodules were detected in 15 patients after antineoplastic chemotherapy,including multiple FNH nodules in 8 cases and sin-gle nodule in 7 cases.The mean detected time of FNH-like nodules was(18.9±11.7)months.Central scarring could be observed during follow-up in 5 nodules,and the rest showed atypical FNH features.Among 45 nodules examined with hepatocyte-specific con-trast medium,36 nodules showed slightly high signal in the hepatobiliary phase and other 9 nodules showed isosignal.Conclusion FNH-like lesions in patients during antineoplastic chemotherapy have certain imaging features,such as lack of central scarring,gener-ally smaller nodules,delayed enhancement,and hyperenhancement in hepatobiliary-specific phase,which are of significant value in the diagnosis and differential diagnosis of the disease.

关 键 词：肿瘤化疗 局灶性结节性增生样病变 肝脏 计算机体层成像 磁共振成像 

分 类 号：R818.051[医药卫生—放射医学] R575[医药卫生—临床医学] R814.42R445.2