Optimized Biphasic Helical CT Images of Focal Nodular Hyperplasia of the Liver

肝臟局部結節增生在最佳化雙相電腦斷層攝影的影像表現

蔡仲明(Chung-Ming Tsai) ； 黃振義(Jen-I Hwang) ； 熊小澐(Siu-Wan Hung) ； 蔡志文(Jyh-Wen Chai) ； 楊明祥(Ming-Shiang Yang) ； 黃姿瑜(Tzu-Yu Huang) ； 李覃(Tain Lee) ； 田雨生(Yeu-Sheng Tyan)

《中華放射線醫學雜誌》 30卷4期 (2005/08) Pp. 205-211

摘要

分析本院肝臟局部結節增生病人在最佳化雙相電腦斷層攝影的影像表現，找出幫助正確診斷的特徵。從1999年到2004年總共蒐集了28位病患共有40個病灶，接受雙相電腦斷層掃瞄包含動脈相與延遲靜脈相。我們分析病灶的數目、大小、位置、邊緣、顯影表現、是否呈現中心疤痕組織、供應或引流的血管等特徵。40個病灶中，直徑大小從1到9.5公分，平均4.2公分，22個小於3公分。典型肝臟局部結節增生的特徵是在動脈相中有非常的高度顯影、在延遲靜脈相中與肝臟同等顯影或因脂肪肝而顯影高於肝臟。大於3公分的病灶較常位於肝臟邊緣，有中心疤痕組織，附近有供應或引流的血管等特徵。不大於3公分的病灶在未注射顯影劑時較常與肝臟呈現相同亮度。最佳化雙相電腦斷層顯示肝臟局部結節增生的特徵，可以給予正確有效的診斷，熟悉這些影像表現可避免不必要的影像檢查、病理切片、開刀。

關鍵字

電腦斷層 ； 局部結節增生 ； 肝臟

並列摘要

To evaluate retrospectively the optimized biphasic computed tomographic (CT) findings of focal nodular hyperplasia (FNH) that might facilitate correct diagnosis.
Biphasic helical CT scans were performed in 28 patients with 40 FNH lesions. Hepatic arterial phase (HAP) and delayed venous phase (DVP) images were obtained initially at 20-25 and 120 seconds, respectively. Diagnosis was based on complete resection (n=9), MRI (magnetic resonance image) (n=12) or CT (n=7) follow-up for a minimum of 6 months without evidence of significant change. We evaluated the number, size, location, margins, surface, homogeneity of enhancement, and presence of central scar, mass effect, calcification, or vessels feeding or draining the lesion. Forty tumors (mean diameter, 4.2 cm; range, 1-9.5 cm) were seen. The large lesion group included 18 nodules larger than 3 cm in diameter. Typical imaging features of FNHs included strong, homogeneous contrast enhancement on HAP images and isodensity to the liver or maybe hyperattenuating in hepatic steatosis on DVP images. The large lesion group usually demonstrated subcapsular location, a thin central scar and peritumoral vessels (p＜0.05). The small lesions (≤3cm in diameter) tend to present isoattenuating on non-enhanced scan more than the large lesions (p＜0.05). Our optimized biphasic protocol using HAP and DVP instead of portal venous phase (PVP) scans demonstrated good detectability and characteristic features of FNH. Such familiarity may help to avoid unnecessary imaging, biopsy, or surgery.

並列關鍵字

Computed tomography CT ； Focal nodular hyperplasia ； Liver