Nishigaki Y, Tomita E, Matsuno Y, Goto K, Ohnishi T, Tanaka Y, Iwai H, Asano H, Yasuda I, Nagura K, Wakahara T, Yamada T
Department of Gastroenterology, Gifu Municipal Hospital, Japan.
J Gastroenterol. 1997 Oct;32(5):677-83. doi: 10.1007/BF02934121.
A 17-year-old woman was admitted because of a liver tumor found incidentally by ultrasonography. Liver function was normal and there were no markers of hepatitis viruses or malignancy. Abdominal ultrasonography, computed tomography (CT), and magnetic resonance imaging revealed a mass (2 cm in diameter) in the lateral segment of the left lobe of the liver. The lesion was not detected by hepatic arteriography. However, dynamic CT with fast scanning and dynamic CO2-enhanced ultrasonography demonstrated initial central enhancement of the mass followed by centrifugal spread of enhancement to the periphery. Color Doppler flow imaging detected a central color spot, shown to be an artery by a pulsed Doppler spectrum analysis. Fine-needle biopsy confirmed a diagnosis of focal nodular hyperplasia. Dynamic CT with fast scanning, dynamic CO2-enhanced ultrasonography, and color Doppler flow imaging were useful in detecting the vascular pattern specific to focal nodular hyperplasia. Investigation of further cases with these novel imaging modalities should help to establish a comprehensive diagnostic procedure and thus avoid unnecessary surgery for focal nodular hyperplasia, which is a completely benign lesion.
一名17岁女性因超声检查偶然发现肝脏肿瘤入院。肝功能正常，无肝炎病毒或恶性肿瘤标志物。腹部超声、计算机断层扫描（CT）和磁共振成像显示肝左叶外侧段有一肿块（直径2 cm）。肝动脉造影未检测到该病变。然而，快速扫描动态CT和动态二氧化碳增强超声显示肿块最初中央强化，随后强化向周边离心性扩散。彩色多普勒血流成像检测到一个中央色点，经脉冲多普勒频谱分析显示为动脉。细针活检确诊为局灶性结节性增生。快速扫描动态CT、动态二氧化碳增强超声和彩色多普勒血流成像有助于检测局灶性结节性增生特有的血管模式。用这些新型成像方式对更多病例进行研究应有助于建立全面的诊断程序，从而避免对局灶性结节性增生进行不必要的手术，因为这是一种完全良性的病变。
