实用肝脏病杂志 ›› 2025, Vol. 28 ›› Issue (4): 605-608.doi: 10.3969/j.issn.1672-5069.2025.04.032

• 肝脏局灶性结节性增生 • 上一篇    下一篇

不典型肝脏局灶性结节性增生MRI征象表现研究*

穆蕤, 李英, 刘萌雪, 杨卫健   

  1. 222000 江苏省连云港市第二人民医院医学影像科(穆蕤,李英,刘萌雪);南京中医药大学附属泰州医院医学影像科(杨卫健)
  • 收稿日期:2025-02-12 出版日期:2025-07-10 发布日期:2025-07-14
  • 通讯作者: 李英,E-mail:1962106828@qq.com
  • 作者简介:穆蕤,男,36岁,大学本科,主管技师。E-mail:mrv0829@163.com
  • 基金资助:
    *江苏省卫生健康委员会科研项目(编号:2023LK0293)

MRI manifestation of atypical focal nodular hyperplasia of the liver: An analysis of 116 cases

Mu Rui, Li Ying, Liu Mengxue, et al   

  1. Department of Radiology, Second People's Hospital, Lianyungang 222000, Jiangsu Province, China
  • Received:2025-02-12 Online:2025-07-10 Published:2025-07-14

摘要: 目的 探讨不典型肝脏局灶性结节性增生(FNH)病灶磁共振成像(MRI)表现。方法 2022年1月~2024年7月我院诊治的116例肝脏FNH患者,于术前接受MRI检查,分析总结平扫、增强和弥散加权成像(DWI)表现。经穿刺或手术后组织病理学检查诊断。结果 在116例肝脏FNH患者,病灶均为单发,肝左右叶均可分布,病灶直径为1.0~11.2 cm,平均为(6.1±1.3)cm。≤2.0 cm者有31个,2.0~5.0 cm者有51个,>5.0 cm者有34个;T1WI呈等信号或稍低信号,T2WI呈等信号或稍高信号,DWI呈稍高信号,动脉期呈高信号,门脉期呈稍高信号或等信号,延迟期呈等信号或低信号,肝胆期呈高信号或等信号;有49个(42.2%)病灶无中央瘢痕,69个(59.5%)有假包膜,43个(37.1%)内部有出血或坏死,37个(31.9%)存在脂肪浸润,56个(48.3%)动脉期强化不明显;>5 cm病灶无中央瘢痕、有假包膜、病灶内出血或坏死、脂肪浸润和动脉期不强化占比分别为64.7%、88.2%、61.8%、52.9%和73.5%,显著高于2.0~5.0 cm病灶的41.2%、56.9%、35.3%、31.4%和47.1%(P<0.05)或≤2.0 cm病灶的19.4%、32.3%、12.9%、9.7%和22.6%(P<0.05)。结论 肝脏FNH病灶存在MRI特征性表现,不典型病灶也具有可鉴别的表现特征,对临床有较大的指导意义。

关键词: 肝脏局灶性结节性增生, 磁共振成像, 病理学, 诊断

Abstract: Objective The aim of this study was to summarize magnetic resonance imaging (MRI) manifestation of atypical focal nodular hyperplasia (FNH) of the liver. Methods 116 patients with liver FNH were encountered in our hospital between January 2022 and July 2024, all underwent plain, enhanced MRIscan, including diffusion weighted imaging (DWI), and the diagnosis was confirmed by biopsies or post-operational histo-pathological examinations. Results Of the 116 patients with liver FNHA, all had solitary intrahepatic nodule, located at right and/or left lobe, with diameters of 1.0to 11.2 cm, averaged with (6.1±1.3)cm, including≤2.0 cm in 31 cases, 2.0-5.0 cm in 51 cases and >5.0 cm in 34 cases; equal or slightly lower signals on T1WI, equal or slightly higher signals on T2WI, slightly higher signals on DWI, high signals at arterial phase, slightly high or equal signals at portal phase, equal or low signals at delayed phase, and high or equal signals at hepatobiliary phase; without central scar in 49lesions(42.2%),with pseudocapsule in 69lesions(59.5%),with internal bleeding or necrosis in 43lesions (37.1%),with fat infiltration in 37lesions (31.9%) and without significant enhancement at arterial phase in 56lesions(48.3%); percentages of without central scar, pseudocapsule, internal bleeding or necrosis, fat infiltration and non-significant enhancement at arterial phase in lesions >5.0cm were 64.7%, 88.2%, 61.8%, 52.9%and 73.5%, all significantly higher than 41.2%, 56.9%, 35.3%,31.4% and 47.1%(P<0.05)in lesions of 2.0 to 5.0 cm or 19.4%, 32.3%, 12.9%, 9.7%and 22.6%(P<0.05)in ≤2.0 cm of lesions. Conclusion Liver FNH, including atypical ones could have specific MRI feature, which might help clinicians make an appropriate measures to deal with.

Key words: Focal nodular hyperplasia of liver, Magnetic resonance imaging, Pathology, Diagnosis