Choi C S, Freeny P C
Department of Radiology, University of Washington School of Medicine, Seattle 98195, USA.
AJR Am J Roentgenol. 1998 Feb;170(2):391-5. doi: 10.2214/ajr.170.2.9456952.
The objective of this paper is to assess the findings of focal nodular hyperplasia of the liver as depicted by triphasic helical CT.
Triphasic helical CT scans (arterial, portal vein, and delayed phase scans) in 12 patients with hepatic focal nodular hyperplasia were reviewed to assess the frequency of findings on each phase. The final diagnosis of focal nodular hyperplasia was proven by surgery or biopsy in eight cases and by additional imaging studies and clinical follow-up in four cases.
Only two of the 12 patients had CT features that could be considered typical of focal nodular hyperplasia. The other patients had one or more findings considered to be atypical and more suggestive of a primary or metastatic hypervascular malignant hepatic neoplasm, such as an enhancing capsule, lack of a central scar, early draining veins, rapid washout of contrast material on the portal vein phase or persistent enhancement on the delayed phase, and interim growth.
Although classic or typical triphasic helical CT manifestations of focal nodular hyperplasia do occur, atypical features are common and can mimic those of primary or metastatic hypervascular hepatic neoplasms. In these latter cases, additional imaging studies, such as a 99mTc-sulfur colloid liver scan, an MR scan, or a percutaneous biopsy, are essential for correct diagnosis.
本文旨在评估螺旋CT三期扫描所显示的肝脏局灶性结节增生的表现。
回顾性分析12例肝脏局灶性结节增生患者的螺旋CT三期扫描（动脉期、门静脉期和延迟期扫描）结果，以评估各期表现的出现频率。8例患者经手术或活检确诊为局灶性结节增生，4例经其他影像学检查及临床随访确诊。
12例患者中仅2例具有可被视为典型局灶性结节增生的CT表现。其他患者有一项或多项表现被认为不典型，更提示原发性或转移性富血供肝脏恶性肿瘤，如包膜强化、无中央瘢痕、早期引流静脉、门静脉期造影剂快速廓清或延迟期持续强化以及病变中期生长。
尽管局灶性结节增生确实会出现经典或典型的螺旋CT三期表现，但不典型特征较为常见，可类似原发性或转移性富血供肝脏肿瘤。在这些情况下，其他影像学检查，如99mTc-硫胶体肝扫描、磁共振扫描或经皮活检，对于正确诊断至关重要。
