CAJ | 학술논문

目的：评价CT及MRI检查对肝脏局灶性结节增生的临床诊断价值。方法回顾性分析10例经病理最终确诊为肝脏局灶性结节增生的患者，分析其CT及MRI影像资料，并与病理进行对照研究。结果其中6例患者行CT扫描，4例患者进行MRI扫描，所有患者均进行增强检查。共观察到病灶10个，病灶位于肝脏左外叶1个，左内叶3个，右前叶3个，右后叶3个，最大平面直径范围为(1.9-4.3cm)，平均3.0±1.2cm。CT病灶6个，平扫呈等密度2个，低密度4个，低密度病灶1例边界清楚，3例病灶边界显示模糊，其中可见更低密度疤痕组织3例。CT增强动脉期显示6例病灶均呈明显强化，中间疤痕组织无强化，6例病灶边界均显示清晰，未见明显包膜；门脉期病灶较动脉期密度降低，但仍较肝脏组织密度高，中间疤痕仍呈低密度；延迟期病灶呈等密度为主，疤痕组织可见强化。MRI检出4个病灶,病灶T1WI呈稍低信号，T2WI呈稍高信号，2例可见中央疤痕，疤痕组织在T1WI上呈低信号， T2WI上呈明显高信号，增强动脉期明显强化,门脉期及延时期呈稍高或等信号,中央疤痕均可见延时强化。结论肝脏局灶性结节增生的CT及MRI影像征象有一定特征性，在诊断及鉴别诊断中有很好的作用，但最终确诊还需要病理证实。
목적：평개CT급MRI검사대간장국조성결절증생적림상진단개치。방법회고성분석10례경병리최종학진위간장국조성결절증생적환자，분석기CT급MRI영상자료，병여병리진행대조연구。결과기중6례환자행CT소묘，4례환자진행MRI소묘，소유환자균진행증강검사。공관찰도병조10개，병조위우간장좌외협1개，좌내협3개，우전협3개，우후협3개，최대평면직경범위위(1.9-4.3cm)，평균3.0±1.2cm。CT병조6개，평소정등밀도2개，저밀도4개，저밀도병조1례변계청초，3례병조변계현시모호，기중가견경저밀도파흔조직3례。CT증강동맥기현시6례병조균정명현강화，중간파흔조직무강화，6례병조변계균현시청석，미견명현포막；문맥기병조교동맥기밀도강저，단잉교간장조직밀도고，중간파흔잉정저밀도；연지기병조정등밀도위주，파흔조직가견강화。MRI검출4개병조,병조T1WI정초저신호，T2WI정초고신호，2례가견중앙파흔，파흔조직재T1WI상정저신호， T2WI상정명현고신호，증강동맥기명현강화,문맥기급연시기정초고혹등신호,중앙파흔균가견연시강화。결론간장국조성결절증생적CT급MRI영상정상유일정특정성，재진단급감별진단중유흔호적작용，단최종학진환수요병리증실。
Objective We used CT and MRI to observe of hepatic focal nodular hyperplasia, and to improve its diagnostic accuracy with CT and MRI.Methods Pathological confirmed of hepatic focal nodular hyperplasia in 10 cases, reviewed the CT and MRI imaging,and to correlation with pathological.Results 6 cases have live CT scan,4 cases have live MRI scan, all the patients have enhanced.10 lesions were observed. 1 lesions located in left lateral lobe, 3 in left inner lobe, 3 in right anterior lobe, 3 in right posterior lobe. The average diameter is 3.0±1.2cm, range(1.9-4.3cm).6 lesions of CT scan, pre-contrast: 4 of 6 lesions were hypodense, 3 lesions were isodense, 1 lesions have smooth edge, 3 lesions have central scar area. On the arterial phase scans, all lesions were markedly and homogeneously enhanced; On portal venous phase: all of the lesions turned to slightly hyperdense, the central scar area were still hypodense. On delayed phase: the lesions turned to isodense, and the central scar area demonstrated late enhancement. 4 lesions showed slightly low signal in T1-weighted images and isointensity or slightly high intensity in T2-weighted images. All lesions had apparent enhancement in the arterial phase and prolonged enhanced in the portal venous phase and delayed phase. Central scar was found in 2 lesions and demonstrated late enhancement.Conclusion High sensitivity of observations imaging findings of hepatic focal nodular hyperplasia by using CT and MRI. it is of great value in diagnosing and differentiating FNH, and the last confirmed diagnostic need pathological.