MSCT多期增强扫描对肝脏局灶性结节增生的诊断价值

目的:探讨MSCT多期增强扫描对肝脏局灶性结节增生(focal nodular hyperplasia,FNH)的诊断价值。方法:回顾性分析经手术及穿刺活检病理证实的9例FNH患者10个病灶的MSCT多期增强扫描表现。结果:9例中8例为单发病灶,1例多发。平扫9个呈低或稍低密度,1个等密度。平扫3个病灶见中央瘢痕;多期增强扫描7个病灶见中央瘢痕,动脉期及门脉期瘢痕均未见强化,延迟期5个见中央瘢痕强化。增强扫描动脉期除中央瘢痕外,8个FNH病灶明显均匀强化,2个中等均匀强化;门脉期病灶密度下降,但均略高于或等于正常肝实质;延迟期病灶密度等于或略低于肝实质。动脉期4个病灶中心或周边见增粗的供血动脉,其中1个为肝动脉分支直接进入病灶中心,1个的供血动脉自病灶中心沿纤维间隔向周边呈放射状分布,另2个周边见供血动脉。结论:MSCT多期扫描可反映病灶的血供特点和病理学特征,对FNH具有重要的诊断及鉴别诊断价值。

MSCT multiphase enhancement scanning in the diagnosis of hepatic focal nodular hyperplasia

Objective：To evaluate the diagnostic value of MSCT multiphase enhancement scan of hepatic focal nodular hyperpla-sia （FNH） .Methods ：Retrospective analysis of 10 lesions of 9 FNH cases confirmed by surgery and biopsy pathology with multiphase enhanced MSCT scanning were performed .Results ：8 of 9 cases of single lesions ,1 case was multiple .Scan 9 showed low or lower density ,one with isodensity .In hepatic arterial phase of enhanced scanning ,except the central scar ,eight FNH lesions showed obvious homogenous enhancement ,2 medium homogenous enhancement .In portal venous phase ,lesions density decreased ,but slightly higher than or equal to the normal liver parenchyma .In delay phase ,lesions density was equal to or slightly below the liver parenchyma .In hepatic arterial phase ,Four lesions saw enlargement of blood supply arteries surrounding the center or shadows ,one for the hepatic artery branch directly into the heart of the lesions ,1 lesion blood supply artery of the lesion center along the fiber spacing to peripheral radial distribution ,the other two saw blood supply artery lesions around .Scan 3 lesions showed central scar ,multiphase enhancement scan 7 lesions showed central scar ,hepatic arterial and portal venous phase of the scar were no enhancement ,delay five central scar enhancement .Conclusion：MSCT multiphase enhancement scan can reflect blood supply and pathological features of lesions ,diagnosis and differential diagnosis is important for FNH .