肝局灶性结节增生患者的典型与不典型螺旋CT征象分析

背景与目的：肝局灶性结节增生（focal nodular hyperplasia,FNH）是一种少见的肝脏肿瘤样病变。本研究旨在探讨该病典型与不典型的螺旋CT征象．从而提高对该病的影像学诊断水平。方法：对中山大学肿瘤防治中心病理证实或临床确诊的32例FNH患者的37个病灶的螺旋CT征象,包括病灶数目、大小、边缘情况、密度、强化形式、中央瘢痕、假包膜等进行比较分析。结果：在37个病灶中,有14个病灶最大径≤3cm,有23个病灶最大径〉3cm;有20个病灶位于肝包膜下;有7个病灶周边存在假包膜,这7个病灶最大径〉3cm;有22个病灶存在中央瘢痕,其中有20个病灶最大径〉3cm。所有病灶在动脉期均呈高密度．其中31个病灶肿瘤实质均匀强化,17个病灶周边可见异常增粗的血管影。结论：FNH典型的cT征象是动脉期明显均匀强化、存在中央瘢痕并延迟强化：FNH不典型的CT征象是动脉期不均匀强化、无中央瘢痕、存在假包膜。征象的多样性与病灶的病理类型和病灶的最大径相关。

Typical and atypical features of focal nodular hyperplasia of the liver on helical CT images

BACKGROUND & OBJECTIVE: Focal nodular hyperplasia (FNH) is a rare hepatic neoplastic lesion. This study was to evaluate the typical and atypical features of FNH of the liver on helical computed tomography (CT) images to improve the diagnosis accuracy. METHODS: Helical CT images of 32 patients with 37 lesions were reviewed in Cancer Center, Sun Yat-sen University retrospectively, who were confirmed as FNH by histopathologic or clinic examinations. The number, size, margin status, density, enhancing type, presence of a center scar, and presence of a pseudocapsule of FNH lesions were analyzed. RESULTS: The largest diameters of 14 lesions were < or = 3 cm, of 23 lesions were > 3 cm; 20 lesions were subcapsular; pseudocapsule was presented in 7 lesions with the largest diameters of > 3 cm; 22 lesions had center scars, among them, the largest diameters of 20 lesions was > 3 cm. All lesions were hyperattenuated to the liver in hepatic arterial phase; 31 lesions were enhanced homogeneously in hepatic arterial phase; abnormally thickened vessels were presented at the border of 17 lesions. CONCLUSIONS: Typical helical CT features of FNH include homogeneous enhancement in hepatic arterial phase, presence of central scar, and delayed enhancement. Atypical helical CT features of FNH include heterogeneous enhancement in hepatic arterial phase, absence of central scar, and presence of pseudocapsule. The various CT features are related to the pathologic type and the largest diameter of the lesion.