Çolaklar Anıl, Lehnert Stephen J, Tirkes Temel
Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Euroasian J Hepatogastroenterol. 2020 Jan-Jun;10(1):42-44. doi: 10.5005/jp-journals-10018-1315.
Fontan procedure, in which systemic circulation is redirected into pulmonary circulation by a baffle, is a palliative surgical strategy for patients born with single ventricle congenital heart disease. Hemodynamic changes secondary to Fontan procedure, also termed as Fontan physiology, result in end-organ damage, especially of the liver. Fontan-associated liver disease (FALD) represents a spectrum of pathologies ranging from mild liver fibrosis to advanced liver cirrhosis and hepatocellular carcinoma (HCC). Hepatic nodules, some of which have been documented as HCC in several case series and reports, are a recognized complicated feature of FALD. Herein, we report a case with benign hepatic nodules mimicking HCC by imaging characteristics, emphasizing the fact that arterially enhancing lesions with delayed washout appearance may reflect benign regenerative or focal nodular hyperplasia-like nodules in patients with Fontan physiology.
Çolaklar A, Lehnert SJ, Tirkes T. Benign Hepatic Nodules Mimicking Hepatocellular Carcinoma in the Setting of Fontan-associated Liver Disease: A Case Report. Euroasian J Hepato-Gastroenterol 2020;10(1):42-44.
Fontan手术是一种针对单心室先天性心脏病患者的姑息性手术策略，该手术通过挡板将体循环重定向至肺循环。Fontan手术继发的血流动力学变化，也称为Fontan生理学，会导致终末器官损伤，尤其是肝脏损伤。Fontan相关肝病（FALD）代表了一系列病理变化，从轻度肝纤维化到晚期肝硬化和肝细胞癌（HCC）。肝结节是FALD公认的复杂特征，在一些病例系列和报告中，其中一些已被记录为HCC。在此，我们报告一例通过影像学特征表现为酷似HCC的良性肝结节病例，强调在Fontan生理学患者中，动脉期强化且延迟廓清的病变可能反映良性再生或局灶性结节样增生性结节这一事实。
Çolaklar A, Lehnert SJ, Tirkes T. Fontan相关肝病背景下酷似肝细胞癌的良性肝结节：一例报告。《欧亚肝脏胃肠病学杂志》2020；10(1):42 - 44。
