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目的探讨肝肝脏局灶性结节增生(focal nodular hyperplasia,FNH)的临床、诊断及治疗。方法回顾性分析24例FNH的临床表现、影像学检查、病理学检查及治疗方法。结果我院近10年来收治24例FNH,大多数无临床症状,占75.0%(18/24),CT扫描有中央星状瘢痕14例,占63.6%(14/22),影像学检查符合率:B超33.3%(6/18),超声造影60.0%(3/5),CT77.3%(17/22),MRI50.0%(2/4),DSA88.8%(8/9),PET-CT100%(5/5),手术切除8例,术后随访1～3年无复发。B超引导下射频消融治疗2例,随访1年,1例病灶消失,1例明显缩小。肝动脉硬化栓塞治疗5例,其中1例破裂出血急诊介入治疗,随访6个月至3年,1例病灶消失,明显缩小4例。继续观察9例,随访1～3年无明显增大。结论 FNH的诊断主要依据影像学检查,对无症状的FNH可继续密切随访,定期观察,对诊断不明或不能排除肝癌者应手术治疗,对诊断明确、有症状或要求治疗者可采用射频消融或肝动脉硬化栓塞治疗,肝动脉硬化栓塞治疗尤其适用于FNH破裂出血。
Objective To investigate the clinical diagnosis, treatment and treatment of focal nodular hyperplasia (FNH) in the liver. Methods Retrospective analysis of 24 cases of FNH clinical manifestations, imaging examination, pathological examination and treatment. Results In the past 10 years, 24 cases of FNH were treated in our hospital. Most of them had no clinical symptoms, accounting for 75.0% (18/24). There were 14 cases of central ascites scarring in CT scan (63.6%, 14/22) : 33.3% (6/18) in B ultrasound, 60.0% (3/5) in ultrasound, CT77.3% (17/22), MRI50.0% (2/4) and DSA88.8% (8/9) , PET-CT100% (5/5), surgical resection in 8 cases, followed up for 1-3 years without recurrence. B ultrasound guided radiofrequency ablation in 2 cases, followed up for 1 year, 1 case disappeared, 1 case was significantly reduced. Hepatic arterial embolization in 5 cases, of which 1 case of hemorrhage emergency interventional treatment, followed up for 6 months to 3 years, 1 case disappeared, significantly reduced in 4 cases. Continue to observe the 9 cases, followed up for 1 to 3 years without significant increase. Conclusion The diagnosis of FNH is mainly based on imaging examination. Asymptomatic FNH can be closely followed up and observed regularly. Patients with unknown diagnosis or liver cancer can be surgically treated. Patients with definite diagnosis, symptomatic or required treatment can be treated with radiofrequency ablation or Hepatic arteriosclerosis embolization, hepatic arteriosclerosis embolization is especially suitable for FNH rupture hemorrhage.