CAJ | 학술논문

　　目的探讨肝脏局灶结节性增生（FNH）的临床特点、影像学表现及治疗策略。方法回顾性分析中国医学科学院肿瘤医院1997年至2012年病理诊断为肝脏局灶结节性增生的71例患者的诊断、治疗及预后等临床资料，结合文献复习讨论其临床特点和治疗策略。结果71例患者中，男性43例，女性28例，年龄（13～53）岁，平均年龄37.0岁。71例患者中的33例（46.5%）有临床症状，主要表现为上腹不适、腹部肿物及乏力；40例（56.3%）患者病灶位于肝左叶，27例（38.0%）患者位于肝右叶，4例（5.7%）患者病灶累及肝左右叶；6例（8.5%）患者为多发病灶，病灶直径0.8～14.0 cm，中位直径4.0 cm。另外，71例患者中行术前超声检查61例，增强螺旋CT检查42例，MRI检查22例；术前超声诊断准确率仅为19.7%（12/61），增强螺旋CT诊断准确率61.9%（26/42），MRI诊断准确率77.3%（17/22）。71例患者均行手术治疗且无明显术后并发症。结论联合多种影像学检查有助于提高肝脏局灶结节性增生的诊断率，对于有临床症状、不排除恶性或病灶在短期内增大的患者应行手术治疗，包括腔镜下肝切除在内的外科治疗对于治疗FNH安全有效。
　　목적탐토간장국조결절성증생（FNH）적림상특점、영상학표현급치료책략。방법회고성분석중국의학과학원종류의원1997년지2012년병리진단위간장국조결절성증생적71례환자적진단、치료급예후등림상자료，결합문헌복습토론기림상특점화치료책략。결과71례환자중，남성43례，녀성28례，년령（13～53）세，평균년령37.0세。71례환자중적33례（46.5%）유림상증상，주요표현위상복불괄、복부종물급핍력；40례（56.3%）환자병조위우간좌협，27례（38.0%）환자위우간우협，4례（5.7%）환자병조루급간좌우협；6례（8.5%）환자위다발병조，병조직경0.8～14.0 cm，중위직경4.0 cm。령외，71례환자중행술전초성검사61례，증강라선CT검사42례，MRI검사22례；술전초성진단준학솔부위19.7%（12/61），증강라선CT진단준학솔61.9%（26/42），MRI진단준학솔77.3%（17/22）。71례환자균행수술치료차무명현술후병발증。결론연합다충영상학검사유조우제고간장국조결절성증생적진단솔，대우유림상증상、불배제악성혹병조재단기내증대적환자응행수술치료，포괄강경하간절제재내적외과치료대우치료FNH안전유효。
Objective To analyze the clinicopathologic characteristics, imaging features and treatment strategies of patients with focal nodular hyperplasia of liver (FNH). Methods The clinicopathologic characteristics, diagnosis, therapy and prognosis of 71 patients with FNH were retrospectively analyzed and the related literatures were reviewed. Results Among the 71 patients, 43 were male and 28 were female, with the average age of 37 years old (13-53 years old). There were 33 cases had clinical manifestations including abdominal discomfort, abdominal mass and fatigue. The lesions of 40 patients lied in the left lobe of liver, 27 in right lobe and 4 in both. There were 6 cases with multiple foci. The median tumor diameter was 4.0 cm (0.8-14.0 cm). The diagnostic accuracies of ultrasound, enhanced CT scan and enhanced MR scan were 19.7%, 61.9% and 77.3%, respectively. All the 71 patients underwent surgical operation and no obvious postoperative complications were observed. Conclusions Combination of various imaging methods is beneficial to the improvement of diagnosis of FNH. Sugical management should be offered to patients with clinical manifestations, ambiguous diagnosis or tumor growth. Surgical resections including laparoscopic liver resection are safe and effective for FNH patients.