肝局灶性结节样增生的CT和MR诊断.docVIP

肝局灶性结节样增生的CT和MR诊断 【摘要】 　　目的 分析肝局灶性结节样增生(FNH)的CT、MR表现水平，旨在提高对FNH的诊断。方法 收集经病理检查证实的FNH 8例、行CT检查7例、行MR检查2例，同时行CT和MR检查1例，并复习有关文献，探讨其CT，MR表现。结果 CT平扫病灶呈均匀或不均匀的低密度，增强扫描动脉期除中央瘢痕外，所有病灶均明显强化，门脉期呈稍高密度，延迟期4个病灶呈稍高或等密度,3个病灶呈稍低密度;3个病灶的中央瘢痕均延时增强。MR平扫病灶呈稍长或等T1、T2信号;增强动脉期示病灶明显增强,门脉期及延时期呈稍高或等信号,病灶的中央瘢痕延时增强。 结论 CT、MRI,尤其是动态增强扫描对FNH的诊断具有重要价值。 【关键词】 X线计算机 核磁共振 局灶性结节样增生　　　　　　　　【Abstract】Objective To evaluate the MR imaging and CT appearance of focal nodular hyperplasia (FNH) of the liver and improve the accuracy of diagnosis in FNH. Methods The CT and MRI findings of 8 patients pathologically confirmed FNH were studied retrospectively. 7 patients were examined by CT and 2 patients were examined by MRI. 1 patient had both CT and MRI examination. Results On plain CT, the lesions showed heterogeneous or homogeneous hypodensity. On postcontrast CT, the lesions showed intense and homogeneous enhancement during arterial phase , except for 3 lesions with the central scar. During portal vein phase, the lesions showed moderate hyperdensity. During delayed phase, 4 leisons remained mild hyperdensity or isodensity and 3 leisons showed hypodensity. 3 lesions with central scars demonstrated delayed enhancement. On MR imageing , the lesion showed slightly long or iso-T1 and T2 signal intensity , demonstrating intense arterial enchancement and moderate portal and delayed enhancement on Gd-DTPA contrast studies. Central scar delayed enhancement. Conclusion MR and CT especially dynamic contrast enhancement is of great value to the diagnosis of FNH. 　　【Key words】 X-ray computed Magnetic resonance imaging Focal nodular hyperplasia 　　　　 　　肝局灶性结节样增生(focal nodular hyperplsia,FNH)是一种较少见的肝脏良性结节状病变，发病率占肝实性占位病变的2.7%，女性多见(约占79%)。发病年龄3个月～64岁，以20～50岁多见。绝大多数病人无明显临床症状，多于体检时偶然发现，仅15%左右可引起症状，常为上腹部疼痛及包块，自发性破裂及腹腔出血少见。本病无恶变可能，长期随访有缩小及自愈倾向，一般无需处理，有临床症状时可行外科手术。 　　1 临床资料 　　1.1 一般资料 　　 　　收集1995年5月至2005年10月在本院CT或/和MR检查并经病理证实的FNH 8例(CT检查7例，MR检查2例，1例同时行CT和MR检查)，其中男3例，女5例，年龄32～42 岁(平均38岁)。病灶均于体检时或无意中发现，均无慢性肝炎、肝硬化的病史，甲胎蛋白(AFP)阴性。