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目的:探讨肝局灶性结节增生(FNH)的CT、MRI及超声造影表现,以提高FNH诊断的准确性。方法:回顾性分析12例经病理及随访证实的FNH影像学资料,所有病例均行B超、CT、MRI检查,其中超声造影6例。结果:FHN病灶B超均呈稍低回声,超声造影时动脉呈中央向周边快速增强,门脉期、延迟期回声逐渐均匀,高于正常肝组织。病灶CT平扫呈低密度7个,等密度5个。MRI平扫T1WI低信号8个,等信号4个;T2WI均呈高或稍高信号。病灶动脉期CT及MRI均明显强化。门脉期CT显示7个等密度,4个稍高密度,1个为略低密度;延迟期9个等密度,2个稍高密度,1个稍低密度;MRI显示高信号9个,等信号3个;延迟期高信号8个,等信号4个。CT扫描示8个病灶有中央瘢痕,5个周边有扭曲、增粗血供,3个有假包膜。MRI扫描示8个病灶有中央瘢痕,5个周边有扭曲、增粗血供,3个有假包膜。MRI扫描示9个病灶有中央瘢痕,5个周边有扭曲,增粗血供,3个有假包膜。CT正确诊断4例(4/12),MRI为6例(6/12),超声造影为5例(5/6)。结论:CT及MRI增强扫描可充分反映FNH的供血特点及病理特征,在FNH诊断与鉴别诊断中具有重要的价值。FNH的“离心性强”的超声造影特点,可提高诊断的准确率。
Objective: To investigate the CT, MRI and contrast-enhanced ultrasound findings of focal nodular hyperplasia (FNH) to improve the accuracy of FNH diagnosis. Methods: FNH imaging data confirmed by pathology and follow-up were retrospectively analyzed in 12 cases. All cases were examined by B-mode ultrasonography, CT and MRI, including 6 cases of contrast-enhanced ultrasound. Results: B-mode FHN lesion showed a slightly lower echogenicity. The contrast-enhanced ultrasonography showed that the arteries were rapidly enhanced to the periphery from the center, and the echoes of the portal venous phase and the delayed phase were gradually more uniform than those of the normal liver tissue. CT lesions showed a low density of 7, such as 5 density. MRI plain T1WI low signal 8, and other signals 4; T2WI were high or slightly higher signal. Focal arterial phase CT and MRI were significantly enhanced. The portal venous phase showed 7 iso-density, 4 slightly higher density, 1 slightly lower density, 9 equally-spaced densities, 2 slightly higher densities, and 1 slightly lower densitome; MRI showed 9 high signals, etc. Signal 3; delay high signal 8, such as the signal 4. CT scans showed eight lesions with central scarring, 5 perimetric distortions, augmented blood supply, and 3 pseudocapsules. MRI scans showed eight lesions with central scarring, five perimetric distortions, thickening of the blood supply, and three false envelopes. MRI scans showed nine lesions with central scarring, 5 perimetric distortions, thickening of the blood supply, and 3 false envelopes. The correct diagnosis of CT in 4 cases (4/12), MRI in 6 cases (6/12), ultrasound in 5 cases (5/6). Conclusion: CT and MRI enhanced scan can fully reflect the characteristics of FNH blood supply and pathological features in the diagnosis and differential diagnosis of FNH has an important value. FNH “Centrifugal ” ultrasound contrast features, can improve the diagnostic accuracy.