【摘要】 目的:探讨肝局灶性结节性增生(FNH)的CT诊断的价值与外科治疗指征。方法:回顾性分析我院2002~2007年以来收治的23例FNH,均行CT扫描、生化检查及病理证实。结果:23例FNH病灶均成孤立结节或分叶状团块,CT平扫多表现为等或稍低密度影,多发生在近肝缘处,动态增强扫描,动脉期病灶均为明显的强化,静脉期及延迟期18例仍略高于肝实质,5例略低于或等于肝实质。17例病灶内显示瘢痕,其中16例呈延迟强化。病理示16例FNH均无包膜,增生的肝细胞形成肝板被纤维间隔分隔成结节状,瘢痕区域有纤维结缔组织及厚壁畸形血管组成。16例行手术切除,术后恢复良好,无手术并发症;7例CT引导下穿刺活检,均获得明确病理诊断。结论:典型的FNH经CT检查可明确诊断,不典型的FNH应与肝细胞腺瘤、肝细胞癌、肝血管瘤相鉴别。无症状的FNH无须手术治疗,但当结节直径>5 cm,病人有症状时,或结节位于中肝,压迫门静脉、下腔静脉时应积极手术切除。更多还原

【Abstract】 Objective: To assess CT value in diagnosis and surgical indications of focal nodular hyperplasia(FNH) of liver.Methods: 23 cases with FNH treated in our department in the past 5 years(2002～2007) were studied retrospectively,all of them were examined with CT and blood tests and proved to be FNH by pathology.Results: All patients had a solitary globular,lobulated mass.On unenhanced CT,focal nodular hyperplasia is classically seen as asolitary,homogeneous,and slightly hypoattenuating area comparedwith normal liver,FNH demonstrated intense homogeneous enhancement during the arterial phase of enhanced imaging and 18 cases demonstrated hypert tenuating,5 cases demonstrated hypoattenuatingor isoattenuating area compared with normal liver during the later phase of enhanced imaging and venousphase.17 cases showed enhancement of the central scar during delayed phases,16 cases showed delayed enhancement at histologic analysis,16 cases of FNH were well limited but nonencapsulated.The hyperplastic parenchymaof the live was subdivided into small nodules that were surrounded by the fibrous septa,there was a central scar composed of fibrous connective tissue and malformed vessels of various caliber.16 cases underwent resection and nopostoperative complicationoccurred and 7 cases was established by needle biospy.Conclusion: The typical FNH can be diagnosed.Atypical cases should be differentiated from hepatocelluar adenoma hepatocellular carcinoma and hemangiomas.Asymptomatic FNH need no operation,but surgical resection is peroformed in the following conditions:diameter of the nodulus is beyond 5cm and with symptome,portal vein or inferior vena cava oppressed by the mass.更多还原