肝脏局灶性结节增生的CT和MRI表现与病理对照分析

目的:探讨肝脏局灶性结节增生(FNH)的CT和MRI表现及病理基础。方法:回顾性分析18例20个经手术或穿刺活检病理证实FNH的CT和MRI表现特点,并与病理对照(CT检查12例,MRI检查10例,4例同时行CT和MRI检查)。结果:病灶大小1.8～13.5cm;CT检出11个病灶,CT平扫病灶均呈低密度,均匀或不均匀;增强扫描动脉期示除中心疤痕灶外,所有病灶均明显增强,6个病灶周边见增粗、扭曲的动脉;门脉期示病灶呈稍高密度,延时期示6个病灶呈稍高或等密度,5个病灶呈稍低密度;5个病灶的中央疤痕均延时增强。MRI检出12个病灶,病灶均呈稍长或等T1及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,7个病灶的中央疤痕延时增强。结论:CT和MRI能够显示FNH的血供特点及病理特征,动态增强扫描是诊断FNH最有效的影像学手段,在诊断和鉴别诊断中具有很大价值。

Focal Nodular Hyperplasia of the Liver:Comparative Study between CT,MRI and Pathology

Objective:To evaluate the CT and MRI findings of hepatic focal nodular hyperplasia (FNH) correlating with pathologic basis.Methods:The CT and MRI findings of 20 patients pathologically confirmed FNH in 18 patients were retrospectively studied and compared with pathological features.Twelve patients were examined by CT,10 patients by MRI,and 4 patients had both CT and MRI examinations.Results:The size of lesions ranged from 1.8~13.5cm.CT found 11 lesions.On precontrast CT,the lesions showed heterogeneous or homogeneous hypo-density.On postcontrast CT,the lesions showed intense and homogeneous enhancement during arterial phase,except for 5 lesions with the central scar.Tor-tuous and dilated arteries were erected around 6 lesions.During portal vein phase,the lesions showed moderate hyper-density.During delayed phase,6 lesions remained mild hyper-density or isodensity and 5 lesions showed hypodensity.5 lesions with central scars demonstrated delayed enhancement.On MR imaging,12 lesions showed slightly long or iso-T1 and T2 signal intensity,demonstrating intense arterial enhancement and moderate portal and delay enhancement on Gd-DTPA contrast studies.Central scar sign 7 lesions showed delayed enhancement.Conclusion:CT and MRI play important roles in the demonstration of blood supply and pathological features of FNH.Dynamic contrast enhancement has a great value in the diagnosis and differential diagnosis of FNH.