肝脏局灶性结节增生的螺旋CT表现及鉴别诊断

目的分析肝脏局灶性结节增生（FNH）在螺旋CT多期扫描中的表现，以提高CT诊断FNH的准确性。方法10例经手术病理证实的FNH均进行螺旋CT平扫、增强动脉期、门脉期及延迟期扫描。结果11个病灶平扫低密度者9个，等密度者2个，其中8个病灶中央有条状、裂隙状以及放射状低密度影。增强动脉期扫描所有病灶除中心瘢痕外，均呈明显且均匀一致的强化，其中3例还可见到病灶中心或周边增粗、扭曲的动脉。门脉期扫描7个病灶为略高密度，4个为等密度。延迟期扫描呈等密度或略低于肝实质，而中心瘢痕者6例有延迟强化，2例无强化。结论抓住螺旋CT多期扫描中的特征性表现，可以提高诊断FNH的准确性。

CT features and differential diagnosis of focal nodular hyperplasia of the liver

Objective To discuss the appearances of focal nodular hyperplasia(FNH) of the liver on the muhiphase helical CT scanning, and to improve its diagnostic accuracy with CT. Methods Helical CT scanning of pre- and post- contrast arterial phase,portal venous phase and delayed phase was performed in 10 cases with surgically and pathologically proved FNH. Results On pre- contrast scans,9 of 11 FNH lesions were hypodense(either homo-geneous or non-homogeneous), the other two lesions were isodense. On the arterial phase scans, all lesions were markedly and homogeneously enhanced,except for the central scar area. Tortuous and dilated arteries were seen at the center or peripheral area in 3 out of 11 lesions. On the portal phase and delayed phase scans ,4 of 11 lesions turned to isedanse of slightly hypodense,7 lesions remained slightly hyperdense. Central scar was found in 8 FNH lesions ,2 of them showed no enhancement while the other six demonstrated late enhancement. Conclusion Mulfiphase helical CT scanning can fully reflect the blood supplying and pathologic features of FNH, and it is of great value in diagnosing and differentiating FNH.