肝脏局灶性结节增生的CT和DSA诊断

 目的 探讨CT和DSA对肝脏局灶性结节增生(focal nodular hyperplasia, FNH)的诊断价值。方法 收集武警四川总队医院2008-06至2016-08经病理证实的5例FNH患者的CT和数字减影血管造影(digital subtraction angiography,DSA)图像,结合文献对其临床、病理和影像表现进行回顾性分析。CT为平扫加多期增强扫描,DSA检查为选择性肝动脉造影。结果 5例均为单发肿块,CT平扫均呈密度不均、边界较清的稍低密度肿块影;增强扫描动脉期病灶均明显强化,其中心为条状或放射状无强化瘢痕影;门脉期病灶呈等密度改变,中心低密度瘢痕影无强化;延迟扫描低密度瘢痕逐渐强化。DSA中病灶表现为富血供占位,供血动脉迂曲、增粗,进入病灶后呈放射状分布显示,染色均匀,境界清楚。结论 FNH的CT多期扫描和DSA表现具有一定的特征性,二者结合对其诊断与鉴别诊断极有价值。

CT and DSA diagnosis of focal nodular hyperplasia of livers

Objective To investigate the diagnostic value of CT and DSA in focal nodular hyperplasia (FNH) of the liver.Methods CT and DSA images of five patients with pathologically proved FNH were collected.The clinical,pathological and imaging findings were analyzed retrospectively.Results These five cases were solitary tumors.CT scan showed low density masses of uneven density,with clear boundaries.In the arterial enhanced scan,lesions were significantly enhanced.The central strip or radial non-reinforcement scar shadow in the portal venous phase lesions showed changes without a strong central scar.In the delayed scanning,the low density scar was gradually strengthened.In the DSA examination,lesions were hypervascular,arterially tortuous and thickening,with radial distribution,dyeing uniformity and clear boundaries in the lesions.Conclusions FNH has some characteristics in multiphase CT scan and DSA performance The combination of the two examination methods is of great value in diagnosis and differential diagnosis.