Yamamoto H, Yamanaka T, Yoshida Y, Miyata M
Department of Surgery, Omiya Medical Center, Jichi Medical School, Saitama, Japan.
Gastroenterol Jpn. 1993 Jun;28(3):424-30. doi: 10.1007/BF02776989.
A 3-cm lesion indicative of focal nodular hyperplasia (FNH) of the liver was coincidentally detected in a 21-year-old female. Ultrasonography (US), computed tomography (CT), magnetic resonance (MR) imaging and liver scintigraphy all proved nonspecific. However, color Doppler US demonstrated characteristic vascular patterns of FNH of the liver, including (a) hypervascularity of the mass, (b) an enlarged afferent blood vessel in the tumor with blood flow toward the center of the tumor, and (c) arterial pulse waves in all the vessels in the lesion, detected by means of the fast Fourier transformation (FFT). With selective hepatic angiography, a "spoke-wheel" pattern was revealed. The angiographic pattern corresponded well to that shown by color Doppler US. On the basis of the findings from these two modalities, the diagnosis of FNH was made. This report examines the effectiveness of color Doppler US in the differential diagnosis of FNH, compared with other imaging modalities.
一名21岁女性偶然发现肝脏有一个3厘米的病灶,提示为局灶性结节性增生(FNH)。超声检查(US)、计算机断层扫描(CT)、磁共振成像(MR)和肝脏闪烁扫描均显示无特异性。然而,彩色多普勒超声显示了肝脏FNH的特征性血管模式,包括:(a)肿块血管增多;(b)肿瘤内传入血管增粗,血流向肿瘤中心;(c)通过快速傅里叶变换(FFT)检测到病灶内所有血管的动脉脉搏波。选择性肝血管造影显示出“辐轮状”模式。血管造影模式与彩色多普勒超声显示的模式非常吻合。基于这两种检查方式的结果,作出了FNH的诊断。本报告探讨了彩色多普勒超声与其他成像方式相比,在FNH鉴别诊断中的有效性。