儿童肝脏局灶性结节增生临床表现与影像学表现关联分析

目的：探讨儿童肝脏局灶性结节增生（FNH）的影像表现，提高对该病影像学特征的认识。方法：回顾性分析6例经病理证实为 FNH 的患儿临床及影像学资料，其中3例患儿发病前确诊患有神经母细胞瘤、急性淋巴细胞白血病和髓母细胞瘤，另外3例患儿无恶性病变病史，均系偶然发现。3例患儿行 MRI 检查，2例患儿行 CT 检查，1例患者行 CT及 MRI 检查，行 CT 检查者全部行增强扫描，2例行 MRI 增强扫描。结果：6例诊断为 FNH 患儿中3例（男2例，女1例，平均年龄8．7岁）存在远隔脏器恶性病变病史，影像学上3例患儿肝脏均呈多发病变，病变最大径2．0～5．2 cm，边界尚清楚，1例可见纤维分隔及中心瘢痕，1例可见引流静脉。其他3例 FNH 患儿（男1例，女2例，平均年龄7．3岁）无恶性病变病史，2例呈单发病变，1例呈多发病变；病变最大径4．3～7．6 cm，边界清楚，2例可见纤维分隔及中心瘢痕，3例均无明确引流静脉显示。结论：增强 CT 及 MRI 检查，尤其是 MSCT 血管成像能真实反映儿童 FNH 的病理学特点及血液动力学改变，对儿童肝脏 FNH 患者影像学特点的认知和了解对于该病的鉴别诊断及临床治疗具有重要意义。

Analysis of clinical and imaging manifestations of hepatic focal nodular hyperplasia in children

Objective:To analyze the clinical and imaging manifestations of focal nodular hyperplasia (FNH)in chil-dren,and to improve the knowledge of imaging characteristics of FNH.Methods:The clinical and imaging materials of 6 ped-iatric patients with pathology proved FNH were retrospectively analyzed.Three patients had the histroy of neuroblastoma, acute lymphoblastic leukemia and medulloblastoma respectively,the other three patients had no history of malignacy.All FNH lesions were revealed by chance.Three patients had MRI,2 patients had enhanced MSCT,and one had both MRI and enhanced CT,2 patients had enhanced MRI.Results:Of the six patients with FNH,3 patients (male,2 patients;female,1 pa-tient;average age,8.7y)had a history of malignancy.They had multiple liver lesions,with the largest dimension as 2.0 ~5.2cm,well defined,with fibrous septa and central scar in 1 patient and draining vein in 1 patient.In the remaining three pa-tients (male,1 patient;female,2 patients;average age,7.3y)had no history of malignancy,showing solitary lesion (2 pa-tients)and multiple lesions (1 patient).The largest dimension was 4.3~7.6cm,with fibrous septa and central scar in 2 pa-tients,no draining vein was assessed in all 3 patients.Conclusion:Enhanced CT and MRI,especially MSCTA can clearly show the pathologic characteristics and hemodynamic change of FNH in children,which is significant in the understanding of imaging characteristics and helpful in the differential diagnosis as well as clinical treatment.