儿童肝脏局灶性结节增生的CT表现与病理特征

发布时间：2018-04-04 05:54

本文选题：肝脏　切入点：局灶性结节增生　出处：《中国医学影像技术》2017年09期

【摘要】：目的探讨儿童肝脏局灶性结节增生(FNH)的CT影像特点与病理特征。方法收集经病理证实的13例FNH患儿,术前均进行CT平扫及增强扫描,分析病灶形态、大小、密度、增强模式等影像学特点,并与病理对照。结果本组13例患儿共16个病灶,病灶位于右叶8个,位于左叶5个,累及2个肝叶3个。瘤体最长径约5.5~11.5cm,中位最长径为7.5cm。2例为典型FNH,11例为非典型FNH。12例病灶形态规则,1例见包膜。CT平扫1例为等密度,余12例为低密度;2例典型FNH见裂隙状、星芒状低密度中央瘢痕。增强扫描动脉期12例明显强化,1例轻度强化,中心瘢痕未见强化,其中12例见明显增粗纡曲的动脉;门静脉期强化程度均不同程度减低,10例呈稍高密度,2例呈等密度,1例呈低密度,2例中央瘢痕轻度强化;延迟期病灶实质部分强化程度持续下降,12例呈等密度,1例呈稍低密度,2例中央瘢痕延迟期强化呈稍高密度。结论儿童FNH的CT表现多样,但有一定特征性,CT平扫及增强扫描可反映其病理变化,了解其CT影像特点,结合临床特征,有助于早期诊断。
[Abstract]:Objective to investigate the CT features and pathological features of focal nodular hyperplasia (FNH) of liver in children.Methods Thirteen children with FNH confirmed by pathology were examined by plain and enhanced CT before operation, and the imaging features such as shape, size, density and enhancement mode were analyzed, and compared with pathology.Results there were 16 lesions in 13 cases, including 8 lesions in the right lobe, 5 lesions in Zuo Ye and 3 lesions in 2 liver lobes.The longest diameter of the tumor was about 5.5 ~ 11.5cm, the median length of 7.5cm.2 was typical FNH.12 (n = 11), atypical FNH.12 (n = 11), regular lesion morphology (n = 1). Plain CT scan (n = 1) showed isodensity, while the other 12 cases (n = 12) with typical FNH showed fissure shape and stellate low-density central scar.In contrast, 12 cases had obvious enhancement in arterial phase, 1 case had slight enhancement, and 12 cases had obvious thickening and tortuous artery.The enhancement degree of portal vein was decreased in different degree in 10 cases, which was slightly high density in 2 cases, and isodensity in 1 case, low density in 2 cases, mild enhancement in central scar in 2 cases.In the delayed stage, the degree of enhancement of the parenchymal part of the lesion continued to decrease. 12 cases showed isodensity and 1 case showed slightly low density and 2 cases showed slightly high density in the delayed phase of central scar enhancement.Conclusion the CT manifestations of FNH in children are various, but the features of CT plain scan and enhanced CT scan can reflect the pathological changes, understand the characteristics of CT images, and combine with clinical features, which is helpful for early diagnosis.
【作者单位】：首都儿科研究所附属儿童医院放射科;上海交通大学医学院附属上海儿童医学中心影像诊断中心;首都儿科研究所附属儿童医院外科;首都儿科研究所附属儿童医院病理科;
【分类号】：R725.7;R816.92

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