Low V, Khangure M S
Department of Diagnostic Radiology, Royal Perth Hospital, W.A.
Australas Radiol. 1990 May;34(2):124-30. doi: 10.1111/j.1440-1673.1990.tb02827.x.
Focal Nodular Hyperplasia (FNH) and Hepatic Adenoma (HA) remain difficult diagnostic problems due to their variable imaging appearances. Five new cases are presented, illustrating this variability, and the current literature is reviewed. Ultrasonography is a sensitive modality for their detection but is otherwise non-specific. On computer tomography, the presence of a scar suggests FNH, whilst haemorrhage suggests HA. However these features are seen in only a small number of cases. Radionuclide (colloid) scanning aids considerably in FNH but a definitive role has not been found in HA. Angiography is helpful, providing anatomical information, sometimes diagnostic (septated blush in FNH, hypovascular areas in HA) and able to discern benign from malignant lesions. Where imaging is not definitively diagnostic, percutaneous biopsy is indicated if FNH is suspected and surgical biopsy if HA is felt likely.
局灶性结节性增生（FNH）和肝腺瘤（HA）因其多样的影像学表现，仍然是诊断难题。本文报告5例新病例，展示了这种多变性，并对当前文献进行了综述。超声检查对其检测很敏感，但缺乏特异性。在计算机断层扫描中，瘢痕的存在提示FNH，而出血提示HA。然而，这些特征仅在少数病例中可见。放射性核素（胶体）扫描对FNH有很大帮助，但在HA中尚未发现其有明确作用。血管造影术很有用，可提供解剖信息，有时具有诊断价值（FNH中的分隔状造影剂充盈、HA中的低血供区域），并能够区分良性和恶性病变。当影像学检查不能明确诊断时，如果怀疑FNH，应进行经皮活检；如果可能是HA，则应进行手术活检。
