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1、螺旋CT多期增强扫描对肝局灶性结节性增生诊断价值【摘要】目的探讨肝局灶性结节性增生(focalnodularhyperplasiaFNH)的螺旋CT表现特点。方法经手术切除病理证实为肝局灶性结节性增生12例患者,术前均行螺旋CT平扫及动态增强扫描。结果12例FNH病灶均呈单发结节或分叶状肿块,肿瘤直径2.1～7.5cm,平均4.7cm。平扫呈等或略低密度,其中8例病灶中央有星芒状更低密度区,4例病灶直径平均大于5.2cm。动态增强扫描,动脉期10例病灶明显强化,密度高于肝实质,2例轻度强化,病灶中央更低密度区均无强化;静脉期期病灶密度稍有下降,9例等于或略高于肝实质,3
2、例低于肝实质;延迟期病灶密度进一步下降,7例等于或略高于肝实质,5例低于肝实质,7例显示中央斑痕,6例延迟强化。结论典型FNHCT平扫为低密度,增强扫描以“快进慢出”为主要特点,其中央星状斑痕为其主要影像学特点,螺旋CT增强显示中央斑痕征是诊断FNH重要征象。【关键词】肝局灶性结节性增生;肝肿瘤;体层摄影术;X线计算机Valueofmullt-timespiralCTcontrastscanninginDiagnosisofhepaticfocalnodularhyperplasiaZHOUChang-gu,YUYong-qing,Huaping,etalThe8Peo
3、ple’shospitalofLinshuicounty,SihuanProvince.1inshui638500,China【Abstract】ObjectiveToevaluatethespiralCTmanifestationsoffocalnodularhyperplasia(FNH)ofliver.Methods12easesofpathologicallyprovenFNHunderwenttriplephasespiralCTscan.ResultsAllpatientshadasolitary.globular,lobulatedmass,themajo
4、rityofcaseswasapproximately2.1-7.5cmindiameter.OnunenhancedCT,focalnodularhyperplasiaisclassicallyseenasasolitary,homogeneous,andslightlyhypoattenuafingareacomparedwithnormalliver.Onthearterialphasescan,markandhomogenousenhancewereseeninallbut2lesionwhiehwasmoderateenhancedwithoutenhance
5、mentofthecentralsear.Ontheportalvenousphasescans,focaldensityweredecreased,butstillshowinghyperdenseorisodenserelativetonormalliverin9lesions.Onthedelayphaseseans,7of12lesionswereslightlyhyperdeuseorisodense,5of12werehypodense.7casesshowedenhancementofthecentralsearduringdelayedphases,6c
6、asesshoweddelayedenhancementAthistologic8analysis.ConclusionFNHispresentedhypodenseonpre-contrase,andobviousenhancementintheearlyarterialphase,andenhancementofthecentralsearindelayphase.thesecharacteristicsofdifferentimagingareusefulfordiagnosingFNHoftheliver.【Keywords】Hepaticfocalnodula
7、rhyperplasia;Hepatictumor;Tomography;X-raycomputer肝脏局灶性结节性增生(foeolnodularhyperplasia;FNH)是一类少见的肝细胞来源的良性肿瘤性病变,一般无临床症状,多在体检或因其他疾病检查时偶然发现,无恶变倾向,一经确诊,无需治疗,所以其诊断意义重大。中央瘢痕是FNH的重要组织学特征,螺旋CT增强扫描能很好地显示病灶及其中央斑痕的强化特点,在FNH的诊断及鉴别诊断中具有重要作用。笔者回顾性分析了12例FNH的CT表现,旨在提高对FNH的CT表现及其诊断价值的认识。1资料
