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目的分析肝局灶性结节增生(FNH)的CT、DSA及18FDG正电子发射体层摄影术(PET)的影像表现,认识FNH的多种影像学特征。资料与方法10例FNH经手术病理证实,回顾分析其多种影像学表现。10例均行CT平扫及动态增强扫描,其中4例行DSA肝动脉造影,2例行18FDGPET显像。结果10例FNH均为单发性结节,位于肝右叶8例,肝左叶2例。肿瘤直径1.1~9.3cm,平均5.1cm。CT检查10例,平扫均为低密度,其中8例病灶(直径均>3.0cm)中央区有星芒状的更低密度区;增强扫描,动脉期9个结节明显强化,1个中等强化,病灶中央更低密度区无强化,2个病灶中央或周边见增粗迂曲血管,其中1个尚可见动脉-门脉、动脉-静脉分流现象;门脉期病灶密度稍有下降,8个高于或等于肝实质,2个低于肝实质;延迟期7个等于或略高于肝实质,3个低于肝实质,5个病灶中央更低密度有强化。血管造影:4例FNH的供血动脉均来自肝动脉系统,供血动脉增粗、扭曲,1例血管分支放射状分布,周围呈环绕状聚集染色,中央局限性缺损,另3个分支血管紊乱并呈抱球征,1个尚见动脉-门脉、动脉-静脉分流。2例18FDGPET显像均未见异常放射性浓聚。结论FNHCT平扫为低密度,增强扫描以“快进慢出”为主要特征,而血管造影显示肝动脉供血为主,表现为供血动脉增粗、扭曲,呈轮辐状向周围发散。这些影像特征有利于FNH的定性诊断。
Objective To analyze the imaging manifestations of CT, DSA and 18FDG positron emission tomography (PET) in patients with focal nodular hyperplasia (FNH) and to find out the various imaging features of FNH. Materials and Methods 10 cases of FNH confirmed by surgery and pathology, retrospective analysis of a variety of imaging findings. Ten patients underwent CT scan and dynamic contrast-enhanced scan. Among them, DSA hepatic arteriography was performed in 4 patients and 18FDGPET imaging was performed in 2 patients. Results 10 cases of FNH were solitary nodules, located in the right lobe in 8 cases, left lobe in 2 cases. Tumor diameter 1.1 ~ 9.3cm, an average of 5.1cm. CT scan in 10 cases, the plain scan were low density, of which 8 cases of lesions (diameter> 3.0cm) in the central area of stellate lower density area; enhanced scan, arterial phase 9 nodules significantly enhanced, a medium In the central lesion and the periphery of the lesion, we can see the thickening and tortuous blood vessels. One of them can still see the phenomenon of artery-portal vein and artery-vein shunting. The density of portal lesion decreased slightly in 8 Higher than or equal to the liver parenchyma, 2 lower than the liver parenchyma; the delay period of 7 equal to or slightly higher than the liver parenchyma, 3 lower than the liver parenchyma, 5 lesions central lower density enhancement. Angiography: The blood supply arteries of 4 cases of FNH were all from the hepatic artery system. The arteries of the FNH were thicker and distorted. One branch of the vessel was radially distributed with surrounding agglomeration stains. The central part of the artery was impaired. Ball sign, a see the artery - portal vein, artery - vein shunt. Two cases of 18FDGPET imaging showed no abnormal radioactive concentration. Conclusions FNHCT scan is of low density. Enhanced scan is mainly characterized by “fast-forward and slow-out”. Angiography shows that the hepatic artery is the main blood supply, which is characterized by thickening and distorting of the feeding artery, diverging around the spokes. These image features facilitate the qualitative diagnosis of FNH.