摘要
目的评价CT及MRI检查对肝脏局 灶性结节增生的临床诊断价值。方法 回 顾性分析10例经病理最终确诊为肝脏局灶 性结节增生的患者,分析其CT及MRI影像 资料,并与病理进行对照研究。结果 其 中6例患者行CT扫描,4例患者进行MRI扫 描,所有患者均进行增强检查。共观察 到病灶10个,病灶位于肝脏左外叶1个, 左内叶3个,右前叶3个,右后叶3个,最 大平面直径范围为(1.9-4.3cm),平均 3.0±1.2cm。CT病灶6个,平扫呈等密度 2个,低密度4个,低密度病灶1例边界清 楚,3例病灶边界显示模糊,其中可见更 低密度疤痕组织3例。CT增强动脉期显示 6例病灶均呈明显强化,中间疤痕组织无 强化,6例病灶边界均显示清晰,未见明 显包膜;门脉期病灶较动脉期密度降低, 但仍较肝脏组织密度高,中间疤痕仍呈低 密度;延迟期病灶呈等密度为主,疤痕组 织可见强化。MRI检出4个病灶, 病灶T1WI 呈稍低信号,T2WI呈稍高信号,2例可见 中央疤痕,疤痕组织在T1WI上呈低信号, T2WI上呈明显高信号,增强动脉期明显强 化, 门脉期及延时期呈稍高或等信号,中 央疤痕均可见延时强化。结论 肝脏局灶 性结节增生的CT及MRI影像征象有一定特 征性,在诊断及鉴别诊断中有很好的作 用,但最终确诊还需要病理证实。
Objective We used CT and MRI to observe of hepatic focal nodular hyperplasia, and to improve its diagnostic accuracy with CT and MRI. Methods Pathological confirmed of hepatic focal nodular hyperplasia in 10 cases, reviewed the CT and MRI imaging,and to correlation with pathological. Results 6 cases have live CT scan,4 cases have live MRI scan, all the patients have enhanced.10 lesions were observed. 1 lesions located in left lateral lobe, 3 in left inner lobe, 3 in right anterior lobe, 3 in right posterior lobe. The average diameter is 3.0±1.2cm, range(1.9-4.3cm).6 lesions of CT scan, pre-contrast: 4 of 6 lesions were hypodense, 3 lesions were isodense, 1 lesions have smooth edge, 3 lesions have central scar area. On the arterial phase scans, all lesions were markedly and homogeneously enhanced; On portal venous phase: all of the lesions turned to slightly hyperdense, the central scar area were still hypodense. On delayed phase: the lesions turned to isodense, and the central scar area demonstrated late enhancement. 4 lesions showed slightly low signal in T1-weighted images and isointensity or slightly high intensity in T2-weighted images. All lesions had apparent enhancement in the arterial phase and prolonged enhanced in the portal venous phase and delayed phase. Central scar was found in 2 lesions and demonstrated late enhancement. Conclusion High sensitivity of observations imaging findings of hepatic focal nodular hyperplasia by using CT and MRI. it is of great value in diagnosing and differentiating FNH, and the last confirmed diagnostic need pathological.
【关键词】局灶性结节增生;肝脏;CT; 病理
【中图分类号】R735.7;R445.3
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2015.05.026
前言
肝脏局灶性结节增生(focal nodular hyperplasia, FNH)是一种 良性肿瘤样病变,由于该病影像及临床表现不典型,传统的影像检查 技术诊断有一定的困难,文献对该病的报道不多,误诊率较高。近年 来随着影像技术发展,CT及MRI多期增强扫描的普及应用,国内对该病 的报道逐渐增多。由于该病为肝细胞反应性良性增生性疾病,目前未 见恶性变报道,临床主要以随访为主,不需要手术切除,为提高对本 病的诊断准确性,本文总结我院10例经手术切除后病理确诊为FNH的CT 及MRI影像表现,探讨CT及MRI对FNH的临床诊断价值。
中国CT和MRI杂志
第13卷, 第 5 期
2015年05月
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