孙雪峰,王晓霞,袁新宇,钟玉敏,杨梅,张晓伦,邹继珍.儿童肝脏局灶性结节增生的CT表现与病理特征[J].中国医学影像技术,2017,33(9):1293~1296
儿童肝脏局灶性结节增生的CT表现与病理特征
CT manifestations and clinical pathology features of hepatic focal nodular hyperplasia in children
投稿时间:2017-03-27  修订日期:2017-07-18
DOI:10.13929/j.1003-3289.201703152
中文关键词:  肝脏  局灶性结节增生  儿童  体层摄影术,X线计算机  病理
英文关键词:Liver  Focal nodular hyperplasia  Child  Tomography, X-ray computed  Pathology
基金项目:
作者单位E-mail
孙雪峰 首都儿科研究所附属儿童医院放射科, 北京 100020  
王晓霞 上海交通大学医学院附属上海儿童医学中心影像诊断中心, 上海 200127  
袁新宇 首都儿科研究所附属儿童医院放射科, 北京 100020  
钟玉敏 上海交通大学医学院附属上海儿童医学中心影像诊断中心, 上海 200127 zyumin2002@163.com 
杨梅 首都儿科研究所附属儿童医院放射科, 北京 100020  
张晓伦 首都儿科研究所附属儿童医院外科, 北京 100020  
邹继珍 首都儿科研究所附属儿童医院病理科, 北京 100020  
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中文摘要:
      目的 探讨儿童肝脏局灶性结节增生(FNH)的CT影像特点与病理特征。方法 收集经病理证实的13例FNH患儿,术前均进行CT平扫及增强扫描,分析病灶形态、大小、密度、增强模式等影像学特点,并与病理对照。结果 本组13例患儿共16个病灶,病灶位于右叶8个,位于左叶5个,累及2个肝叶3个。瘤体最长径约5.5~11.5 cm,中位最长径为7.5 cm。2例为典型FNH,11例为非典型FNH。12例病灶形态规则,1例见包膜。CT平扫1例为等密度,余12例为低密度;2例典型FNH见裂隙状、星芒状低密度中央瘢痕。增强扫描动脉期12例明显强化,1例轻度强化,中心瘢痕未见强化,其中12例见明显增粗纡曲的动脉;门静脉期强化程度均不同程度减低,10例呈稍高密度,2例呈等密度,1例呈低密度,2例中央瘢痕轻度强化;延迟期病灶实质部分强化程度持续下降,12例呈等密度,1例呈稍低密度,2例中央瘢痕延迟期强化呈稍高密度。结论 儿童FNH的CT表现多样,但有一定特征性,CT平扫及增强扫描可反映其病理变化,了解其CT影像特点,结合临床特征,有助于早期诊断。
英文摘要:
      Objective To investigate the CT features of hepatic focal nodular hyperplasia (FNH) in children. Methods Thirteen patients with FNH, which was confirmed by postoperative pathology, were enrolled retrospectively. Plain and contrast CT were performed on all patients before operation. The CT imaging features of FNH including size, shape, density, style of contrast were analyzed retrospectively and compared with pathology. Results There were 13 patients with 16 lesions, 8 lesions were found in the right lobe, 5 lesions in the left lobe and 3 lesions involving both lobes. The tumor size ranged from 5.5 cm to 11.5 cm (media size 7.5 cm) in diameter. Histologically, 2 cases were typical type, 11 cases were atypical type. The lesions were regular morphology in 12 cases and 1 case with capsule. On plain CT, the lesions were isodensity (n=1) or slightly low-density (n=12). In 2 typical type lesions, there were slit-like, stellate-shaped low density central scars. Arterial phase demonstrated that 12 cases were significantly enhanced and 1 case showed mild enhancement. The central scar was not enhanced. In 12 cases, thickened and torturous arteries were seen. The enhancement was reduced at the portal venous phase in all the lesions, with 10 cases showing slightly higher density, 2cases isodensity and 1 case low-density. Two cases showed mild enhancement of the central scar. The enhancement of the solid portion in all lesions decreased at the delay phase, with 12 cases showing isodensity and 1 case slightly low density. Two cases with central scar showed delayed enhancement with slightly higher density. Conclusion The CT features of FNH in children are diversified but distinctive which are related with postoperative pathological findings. Combining with clinical symptoms and CT features can be helpful for the early diagnosis of FNH in children.
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