多层螺旋CT平扫及增强扫描在肝脏局灶性结节性增生中的诊断价值

目的探讨多层螺旋CT平扫及增强扫描在肝脏局灶性结节性增生(hepatic focal nodular hyperplasia,FNH)中的诊断价值。方法选择FNH患者及肝细胞癌患者各30例,均接受螺旋CT平扫及增强扫描。观察肝细胞癌与FNH大小及分布情况,比较肝细胞癌与FNH的螺旋CT平扫及增强扫描特征。结果 1 FNH位于肝包膜下16例(53.33%),显著高于肝细胞癌(20.00%),差异具有统计学意义(P0.05)。2肝细胞癌平扫表现为等或略低密度,内部可显示低密度囊变坏死区及高密度出血。FNH平扫表现为等或略低密度,其中心显示星芒状低密度区。肝细胞癌及FNH呈快进快出强化,FNH中心星芒状瘢痕区域于延迟期强化。与肝细胞癌比较,FNH存在中心瘢痕的比例更高,伴有门静脉癌栓及肝硬化的比例更低,其差异均具有统计学意义(P0.05)。结论螺旋CT可以清晰显示FNH的影像学特征,有助于诊断和鉴别诊断。

Value of multislice spiral CT scan and enhanced scan in the diagnosis of hepatic focal nodular hyperplasia

Objective To investigate the value of multislice spiral CT scan and enhanced scan in the diagnosis of hepatic focal nodular hyperplasia （FNH）.Methods Thirty cases of FNH and 30 cases of hepatocellular carcinoma （HCC） underwent spiral CT scan and enhanced scan.The size and distribution of HCC and FNH were observed,spiral CT scan and enhanced scan features were compared.Results ① There were 16 cases （53.33％） of FNH subcapsular,significantly higher than 20.00％ of the HCC,the difference was statistically significant （P ＜ 0.05）.② HCC CT scan showed equal or slightly low density,internal low-density cystic necrotic areas and high-density hemorrhage.The FNH CT scan performanced equal or slightly low density,the center showed a stellate-shaped low-density area.HCC and the FNH showed rush out enhancement,FNH center stellate-shaped scar area to strengthen in the delayed phase.The proportion of a central scar in FNH was significantly higher than HCC.The proportion of portal vein tumor thrombus and cirrhosis in HCC were significantly higher than FNH,and the difference had statistical significance （P ＜ 0.05）.Conclusion Spiral CT can clearly show the characteristics of FNH,has a high value in the diagnosis and differential diagnosis.