磁共振成像对肝局灶结节性增生的诊断价值

目的评估磁共振成像（MRI）对肝局灶结节性增生（focal nodular hyperplasia,FNH）的诊断价值.方法前瞻性分析15例经病理证实FNH的MRI平扫、多时相动态增强表现和诊断.结果 13例为单发病灶,1例8个病灶,1例10个病灶.T1WI上26个病灶为稍低或等信号、5个病灶为稍高信号,T2WI上28个病灶呈稍高信号、1个病灶等信号、2个病灶稍低信号;29个病灶在注射Gd-DTPA后动脉期明显增强、门静脉期和延迟期增强的程度下降;2个病灶无增强.14个病灶检出瘢痕,T1WI呈低信号、T2WI高信号,动脉期无增强、门静脉期或延迟期增强.2例少血供和2例多发病灶在应用超顺磁氧化铁之后T2WI的信号明显降低.14例准确诊断为FNH,1例诊断为良性病变.结论 MRI能显示FNH的特征性改变并在术前正确诊断多数FNH.

Diagnostic value of MRI for focal nodular hyperplasia of liver

Objective To determine the value of MRI for diagnosis of focal nodular hyperplasia (FNH)of the liver.Methods The precontrast and postcontrast MR images of 15 cases of pathologi- cally proved FNH were prospectively analyzed.Results Solitary lesions were found in 13 out of the 15 cases.Of these 13 cases,1 had 8 lesions and 1 had 10.Twenty-six lesions were slightly hypoin- tense or isointense and 5 hyperintense on T_1 WI.Twenty-eight lesions were slightly hyperintense,1 isointense and 2 hyperintense on T_2 WI.Twenty-nine lesions showed strong enhancement during the arterial phase but slight or no enhancement during the portal venous phase.There was no enhancement in 2 lesions during the arterial phase,portal venous phase and delayed phase.The central scar was de- tected in 14 lesions.These 14 lesions,which were hypointense on T_1 WI and hyperintense on T_2 WI, showed no enhancement during arterial phase and portal venous phase but slight or moderate enhance- ment during the delayed phase.FNH was correctly diagnosed in 14 cases and benign tumor in 1.Con- clusions MRI findings can reveal the typical features of FNH.So it can be used to diagnose most of the cases of FNH of the liver before operation.