肝脏局灶结节性增生的诊断和治疗

目的 探讨肝脏局灶结节性增生(focal nodular hyperplasia,FNH)的诊断和治疗方法.方法 对1997-2007年期间收治并经手术病理证实的32例FNH的临床资料进行回顾性分析.结果 32例病人中40岁以下占65.6%,男性多见(71.9%),多无临床症状(59.4%),AFP均为阴性.病灶多为单发(90.6%),平均直径3.0 cm(1.0～8.0 cm).术前B超诊断符合率仅为6.5%(2/31),增强螺旋CT诊断符合率45.5%(10/22),MRI诊断符合率80.0%(4/5).超声造影诊断符合率50.0%(2/4).结论 MRI和螺旋CT是诊断FNH的重要手段.结合多种影像手段,有助于提高FNH的诊断率.对诊断不明确或症状较为明显的,以及病灶进行性增大的病人应行手术切除.

Diagnosis and treatment of focal nodular hyperplasia of liver: a retrospective analysis of 32 cases

Objective To explore the diagnosis and treatment of focal nodular hyperplasia of the liver (FNH).Methods The clinical data of 32 patients with pathologically confirmed FNH treated in our hospital from 1997 to 2007 were retrospectively analyzed.Results For the 32 FNH patients, 21 (65.6%) were under 40 years old, 23 (71.9%) were male and 19 (59.4%) were asymptomatic.The alpha fetoprotein (AFP) was negative in all the patients.Twenty-nine patients had single focus with a mean diameter of 3.0 cm (1.0-8.0 em).The correct diagnostic rate of the disease by BUS, CT, MRI and contrast enhanced ultrasound was 6.5%(2/31), 45.5%(10/22), 80.0%(4/5) and 50.0%(2/4), respectively.Conclusion CT and MRI play an important role in the diagnosis of FNH and their com-bination with imaging methods can improve the diagnostic rate.Surgical resection should be suggested to patients with symptoms, indefinite diagnosis or tumor growth.