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目的探讨肝局灶性结节性增生(focal nodular hyperplasia FNH)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。
Objective To investigate the features of spiral CT in focal nodular hyperplasia (FNH). Methods Twelve patients with focal nodular hyperplasia confirmed by pathology were scanned with spiral CT and dynamic contrast-enhanced before operation. Results All 12 FNH lesions showed solitary nodules or lobulated tumors. The diameter of tumors was 2.1-7.5 cm (average 4.7 cm). Plain scan showed equal or slightly lower density, of which 8 cases of central lesion with stellate lower density, 4 lesions diameter average greater than 5.2cm. Dynamic enhanced scan, arterial phase 10 lesions were significantly enhanced, the density higher than the liver parenchyma, 2 cases of mild enhancement, lesion in the lower central density were no enhancement; venous phase lesion density decreased slightly, 9 cases were equal to or slightly higher than Liver parenchyma, 3 cases lower than the liver parenchyma; Delayed lesions density further decreased, 7 cases were equal to or slightly higher than the liver parenchyma, 5 cases lower than the liver parenchyma, 7 cases showed central scar, 6 cases of delayed enhancement. Conclusions The typical FNHCT scan is low density. The enhanced scan is mainly characterized by “fast forward and slow exit”. The central stellate scar is the main imaging feature. Spiral CT enhancement of the central scar mark is an important sign of FNH diagnosis.