首页> 中文期刊> 《影像诊断与介入放射学》 >肝脏局灶性结节性增生的MSCT诊断与鉴别诊断

肝脏局灶性结节性增生的MSCT诊断与鉴别诊断

         

摘要

Objective To evaluate the MSCT findings of focal nodular hyperplasia (FNH) of the liver, and to improve the diagnostic standard. Methods The MSCT findings were analyzed retrospectively in 25 patients pathologically approved with FNH. All patients underwent 16 detector row spiral CT scanning with and without contrast enhancement. Results 28 lesions were discovered by CT, with single lesion showed in 22 cases, 2 lesions showed in 3 cases. All lesions showed a solitary nodules or lobulated mass in the liver. On plain CT, FNH showed equal or slightly low density. In the arterial phase, 27 lesions were vigorously and homogeneously enhanced, except the central scars with CT value of 99~149HU and the mean CT-number of 124 HU. 1 lesion was enhanced inter-homogeneously. Tortuous and enlarged arteries were seen at the center or periphery in 8 of the 28 lesions. In the portal venous phase, 16 lesions remained slightly hyperdense, 8 lesions turned to isodense, and 1 lesion turned to slightly hypodense. The typical central scar was showed in 8 lesions and 2 lesions showed delayed enhancement. 21 cases were correctly diagnosed by MSCT, with the diagnostic accuracy of 84.0%. Conclusion MSCT scanning can fully show the pathologic and the blood supplying characteristics of FNH. The typical FNH can be easily diagnosed by CT, while the atypical cases should be differentiated from hepatocellular carcinoma, hemangioma of liver, liver cell adenoma and fibrolamellar hepatocarcinoma.%目的 探讨肝脏局灶性结节性增生(FNH)的多层螺旋CT表现,以提高对本病的诊断水平.方法 回顾性分析经病理证实的25 例 FNH 的CT表现,所有病灶均行16层CT平扫及动态增强扫描.结果 本组共检出28个病灶,22例单发病灶,3例2个病灶,均为结节或分叶状肿块,平扫为等或稍低密度,增强扫描27病灶动脉期除去中心疤痕外,全部病灶均为显著均匀性强化,CT值为99~149HU,平均124HU,1个病灶呈中度不均匀强化,8例中心或周边见增粗供血动脉.门脉期病灶表现多样,16例为稍高密度,8例为等密度,1例为稍低密度;8例病灶见典型的中心疤痕,其中2例延迟期疤痕强化.CT正确诊断21例,准确率为84.0% 结论多排螺旋CT动态增强扫描能较全面显示大多数FNH的病理特征及血供特点,对典型FNH能够做出正确诊断,非典型FNH要和肝细胞肝癌、肝血管瘤、肝细胞腺瘤、纤维板层样肝癌鉴别.

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