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目的通过分析肝脏局限性结节状增生(FNH)的多排螺旋CT(MSCT)及MRI表现与相应的病理改变,探讨MSCT及MRI对FNH的诊断价值。方法回顾性分析泰安市中心医院及泰山医学院附属医院22例24个经手术或穿刺活检病理证实FNH的MSCT和MRI表现特点,并与病理对照。MSCT检查13例,MRI检查9例,在22例中有4例既行MSCT检查又行MRI检查。结果 (1)MSCT及MRI平扫:MSCT检出14个病灶,平扫病灶均呈均匀或不均匀的等或稍低密度改变,9例病灶见低密度中央瘢痕,呈裂隙状、星芒状改变。MRI检出10个病灶,呈等或稍长T1、T2信号,7例病灶见中央瘢痕。DWI显示10例,其中高信号1例,略高信号9例。(2)MSCT及MRI增强扫描:MSCT增强扫描,动脉期除中央瘢痕外,病灶均明显增强,6个病灶内或周边见扭曲、增粗的供血动脉。门脉期病灶呈稍高密度,延时期12个病灶呈等或稍高密度,2个病灶呈稍低密度,9个病灶的中央瘢痕均延时增强。MRI增强动脉期病灶增强明显,门脉期及延时期呈等或稍高信号,6个病灶中央瘢痕延时增强。结论 MSCT和MRI平扫及三期动态增强扫描能准确显示FNH的病理改变及血流动力学特征,MRI较MSCT略有优势,二者相结合在FNH的诊断及鉴别诊断中具有较高临床价值。
Objective To investigate the diagnostic value of MSCT and MRI for FNH by analyzing multi-slice spiral CT (MSCT), MRI findings and corresponding pathological changes of focal nodular hyperplasia (FNH) in liver. Methods A retrospective analysis was performed on the features of MSCT and MRI in 24 cases of FNH confirmed by surgery or biopsy in Taian Central Hospital and Taishan Medical College Affiliated Hospital. 13 cases were detected by MSCT and 9 cases by MRI. In 4 of 22 cases, both MSCT and MRI were performed. Results (1) MSCT and MRI plain scan: MSCT detected 14 lesions, plain lesions were uniform or uneven or slightly lower density changes, 9 cases of low-density central scar lesions were showed fractal, stellate change. MRI detected 10 lesions, showed equal or slightly longer T1 and T2 signals, and 7 lesions showed central scar. DWI showed 10 cases, of which 1 case of high signal, slightly higher signal in 9 cases. (2) MSCT and MRI enhanced scan: MSCT enhanced scan, except for the central scar during the arterial phase, the lesions were significantly enhanced, within or around the lesion 6 see twisted, thickening of the feeding artery. The portal venous lesions showed a slightly higher density, with 12 lesions of equal or slightly higher densities in delaying period, slightly densified lesions in 2 lesions, and prolonged central scars in 9 lesions. MRI enhancement of arterial phase lesions were significantly enhanced, portal phase and delayed phase was slightly higher signal, 6 lesions central scar delay increased. Conclusion MSCT and MRI plain scan and dynamic enhanced three-phase scanning can accurately show the pathological changes and hemodynamic characteristics of FNH. MRI has some advantages over MSCT. The combination of the two has a high clinical value in the diagnosis and differential diagnosis of FNH .