螺旋CT对肝脏局灶性结节增生的诊断与鉴别诊断

目的：探讨肝脏局灶性结节增生平扫和动态增强的多层螺旋CT表现，总结CT诊断肝脏局灶性结节增生的要点，提高与其他血管丰富的恶性肿瘤的鉴别诊断能力。方法：回顾性分析临床与病理证实的32例肝脏局灶性结节增生的CT平扫与增强后的表现。结果：共检出36个病灶，28例为单发病灶，4例2个病灶。CT平扫病灶均呈等密度或轻微低密度，均匀或不均匀；增强扫描动脉期除中心瘢痕外，所有病灶均有明显的均匀强化，其中19个病灶中心或周边见增粗、扭曲的供血动脉；门脉期病灶呈稍高密度，延时期病灶呈等密度；17个病灶伴有中心瘢痕者均有延迟强化，CT正确诊断28例，诊断符合率87．5％。结论：多层螺旋CT动态增强扫描能较全面显示肝脏局灶性结节增生的病理特征和血供特点，对大部分肝脏局灶性结节增生在术前作出正确诊断。明显地提高与血管丰富的肝细胞癌及肝血管瘤等的鉴别诊断能力，避免误诊。

Diagnosis and Differential Diagnosis of Spiral CT on Hepatic Focal Nodular Hyperplasia

Objective To investigate unenhanced and dynamic contrast-enhanced multi-slice spiral CT of the hepatic focal nodular hyperplasia, sum up the main points of CT diagnosis of hepatic focal nodular hyperplasia and improve differential diagnosis ability with other vascular-rich malignant tumors.Methods The CT scan with the enhanced performance of 32cases of hepatic focal nodular hyperplasia confirmed by clinic and pathology were retrospectively analyzed.Results36lesions were found,28 cases were single lesions,4 cases had 2 lesions.CT scan lesions showed isodense or slightly low density, homogeneous or inhomogeneous; in enhanced scan arterial phase, except central scar,all lesions were significantly enhanced the uniformity,of which 19 lesions were central or peripheral, see thickening, distorted blood supply artery; portal venous phase lesions was slightly higher density, delay period showed lesions such as density; 17 lesions were associated with central scar were delayed enhancement, CT correctly diagnosed 28 cases, diagnostic accuracy rate was 87.5%. Conclusion The dynamic contrast-enhanced multi-slice spiral CT scan can show a more comprehensive hepatic focal nodular hyperplasia of the pathological characteristics and the blood supply, make a correct diagnosis on the majority of focal nodular hyperplasia of the liver and before surgery, and significantly improve the differential diagnosis ability on the wealth hepatocellular carcinoma and liver blood vessels hemangioma to avoid misdiagnosis.