应用MRI技术对肝脏局灶结节性增生的诊断

目的 评估磁共振成像（magnetic resonance imaging,MRI）技术对肝脏局灶结节性增生（focal nodular hyperplasia,FNH）的诊断价值.方法 回顾性分析齐齐哈尔市第一医院2008年1月至2010年4月经手术切除或穿刺活检病理证实的10例26灶FNH 磁共振平扫、动态增强表现,由3名有经验的医师做MR表现诊断.结果 对于10例中的26个病灶,平扫T1WI上23个病灶为稍低或等信号、3个病灶为稍高信号;T2WI上23个病灶呈稍高信号、1个病灶等信号,2个病灶呈稍低信号.在动脉期5个病灶明显不均匀增强、19个病灶显著均匀增强,门静脉期和延迟期13个病灶呈稍高信号,11个病灶呈等/稍低信号,2个病灶无强化.11个病灶检出瘢痕,T1WI呈低信号,T2WI呈低或高信号,动脉期无增强、门静脉期或延迟期增强.8例诊断正确,1例诊断为良性病变（定性困难）,1例误诊为恶性肿瘤.结论 MRI能显示单发或多发FNH的特征性改变,并在术前正确诊断大部分FNH.

The Value of MRI in the Diagnosis of Hepatic Focal Nodular Hyperplasia

Objective To evaluate the diagnostic value of MR imaging in hepatic focal nodular hyperplasia（FNH）. Methods ten cases with 26 lesions, which were confirmed with the biopsy pathology of puncture or surgery,were included in the First Hospital of Qiqihaer city from January 2008 to April 2010. The MR images of 10 cases were investigated retrospectively by 3 experienced physicians. Results Twenty-three lesions showed isointense/slight hypointense and 3 lesions of hyperintense on T1WI. Twenty-three lesions were slight-hyperintense, l lesion of isointense and 2 lesions of hypointense on T2WI. Five lesions showed heterogenously strong enhancement and 19 lesions,homogenously strong enhancement during arterial phase after injection of Gd-DTPA,and 13 lesions of slight hyperintense and 11 lesions of isointense or hypointense during portal venous and delayed phase. Central scar was detected in 11 lesions, which was hypointense on T, WI and hypointense to hyperintense on T2WI. two cases showed no enhancement during arterial phase, portalvenous phase and delayed phase. Eight cases were diagnosed correctly, 1 case was diagnosed as benign focus （characteristically difficult） , 1 case was mistaken as malignant tumor. Conclusions The MR imaging findings of FNH are specific and it is possible that most of FNH can be diagnosed combining case history.