FNH肝局灶性结节性增生.ppt

Outline FNH accounts for approximately 8% of all primary hepatic tumor and is the second most common benign liver tumor after hemangioma. This benign tumour occurs most commonly in women aged 20–50 years, but may occur in both men and women at any age, with multiple lesions being found in 20 per cent of cases. Clinical symptoms FNH is usually an incidental finding at imaging and only one-third are discovered because of clinical symptoms such as mild epigastric pain or discomfort and or palpable abdominal mass . Blood liver tests are normal in half of the cases and show only increased in serum gamma-glutamyl-transpeptidase血清r-谷氨酰转肽酶 activity in most of the remnants . Pathological appearance classic(80%) non-classic(20%) CT T1 WI T2WI Rarely, scars remain hypodense or isodense on delayed scans or are hypointense on T2-weighted images. These findings may be observed up to 20% of cases . Nearly all FNHs are hypervascular at the arterial phase of the enhancement, but lesion enhancement may vary at the portal phase or on delayed images. Both hypodensity or intensity of the mass on delayed phase, or on both portal vein and delayed phase images as well as hyperdensity-intensity of the mass on the portal vein phase or on both portal vein and delayed phases may be seen . Although FNH is a non-encapsulated lesion, capsule like enhancement may be observed on portal vein and on delayed phase scans in about 25–36% of the cases . The pseudocapsule(假包膜) is hypointense on T1 and slightly hyperintense on T2. Differential diagnosis 肝囊肿Hepatic cyst 肝囊肿Hepatic cyst 原发性肝癌primary hepatic carcinoma 原发性肝癌primary hepaticcarcinoma * * 肝局灶性结节性增生 Focal nodular hyperplasia (FNH) FNH Oral contraceptive口服避孕药 use is associated with FNH but the responsibility of oral contraceptives in the occurrence of the lesion has not been demonstrated. well-circumscribed lobulated mass with central scar (arrow) and r