肝局灶性结节增生的CT诊断与鉴别诊断

目的研究肝局灶性结节性增生（focal nodular hyperplasia,FNH）的CT表现，提高对本病的诊断与鉴别诊断水平。方法回顾性分析经病理证实的12例FNH的CT表现，所有病例术前均行CT平扫及双期增强扫描。结果12例FNH病灶均有典型的CT表现，均呈孤立结节或分叶状肿决，其中10侧位于近肝表面包膜下，直径约为2—6cm。平扫呈等或稍低密度，增强扫描动脉期均为明显全瘤均匀性强化，强化高于正常肝而接近于同层腹主动脉，门静脉期9例下降到稍高密度，3例为等密度，其中4例显示典型中央瘢痕组织，1例中央瘢痕延迟扫描后出现强化。结论CT可以明确诊断典型的FNH，不典型的FNH应与肝细胞腺瘤、肝细胞癌、纤维板层肝细胞癌、肝血管瘤鉴别。

CT diagnosis and differential diagnosis of hepatic focal nodular hyperplasia

Objective To evaluate the CT findings of focal nodular hyperplasia（FNH） of the liver, and to raise the standard with the diagnosis and differential diagnosis of the disease. Methods 12 cases with FNH proven pathologically underwent plain and dualphase enhanced CT scans. All the manifestations of CT were analyzed retrospectively. Results 12 cases with FNH were a solitary globular or lobulated mass, of which 10 cases under the surface of liver peplos were approximately 2-6cm in diameter.On plain CT, FNH showed equal or slightly low density, and showed obviously homogeneous enhancement that was super-density compared with normal liver and was close to abdominal aorta during the arterial phase. 9 cases with FNH showed slightly high-density,3 cases showed isodensity during the venous phase,and the typical central scar was showed in 4 cases and 1 case showed delayed enhancement. Conclusion The typical FNH can be easily diagnosed by CT, while the atypical cases should be differentiated from hepatocelluar adenoma, hepatocellular carcinoma, fibrolamellar hepatocellar carcinoma and hemangioma of liver.