肝局灶性结节性增生的超声和CT对照分析

目的 探讨肝局灶性结节性增生（FNH）的超声和CT表现及其诊断价值。方法 15例住院病例行超声与CT检查。结果 15例FNH均经手术及病理证实，共有16个病灶，其中右叶9个，左叶6个，尾叶1个，B超和CT均全部检出，B超多表现为低或略低回声（88%），可有浅淡暗环（44%）；彩色多普勒显示有粗大血管进入病灶内并分支（81%），可呈轮辐状血流（19%），脉冲多普勒均测及动脉血流，阻力指数平均为0.54。CT表现为病灶增强后，早期明显强化（100%），星状疤痕显示率为44%，门静脉期及延迟扫描多呈等密度（75%），常规B超联合彩色多普勒超声诊断FNH的符合率为50%；CT诊断FNH的符合率为50%。结论 常规超声联合彩色多普勒超声和CT增强结合动脉扫描可提高FNH的诊断准确性。

Diagnosis of the hepatic focal nodular hyperplasia by ultrasonography and CT

Objective　To evaluate the value of the ultrasound and the helical CT in the diagnosis of hepatic focal nodular hyperplasia(FNH).Methods　Fifteen patients with 16 lesions were examined by B-mode ultrasound ,color Doppler ultrasound and helical CT. All of them were proved to be FNH by pathology.Results　In these patients, the hypoechoic pattern with homogeneous solid lesions was mostly displayed on B-mode ultrasound, and the central stellate scar was only found in 1 lesion. A color blood flow with arterial spectrum was detected within central area of FNH in 13 lesions, and spokewheel color flow was depicted in 3 lesions. These color flow patterns were specific for FNH. All lesions were hypervascular and homogeneous on arterial phase scans of CT. The central scars were detected in 7 lesions, and a dilated feeding artery was seen in 8 lesions on the arterial phase scans. The isodense changes were displayed in 11 lesions on the portal phase or delayed phase.Conclusions　The conventional ultrasound combined with color Doppler ultrasound and CT combined with dynamic scan can raise the accuracy for the diagnosis of FNH.