目的探討肝臟局灶性結(jié)節(jié)增生(focal nodular hyperplasia, FNH)的診斷和治療經(jīng)驗(yàn)。方法回顧性分析兩所醫(yī)院1996年4月至2001年4月5年間收治并經(jīng)病理證實(shí)的21例FNH的臨床、影像學(xué)和病理學(xué)資料。結(jié)果FNH術(shù)前正確診斷率較低(19.0%)，該病多見(jiàn)于中、青年(50歲以下占81.0%)，多無(wú)癥狀(57.1%)，多無(wú)乙型肝炎病毒感染(95.2%)，肝功能和AFP檢查均正常(100%)； 彩色多普勒檢查發(fā)現(xiàn)80.0%(12/15)的病灶有血管通過(guò)，66.7%(10/15)的病灶血流豐富； CT動(dòng)態(tài)掃描增強(qiáng)后60.0%（9/15)早期顯著強(qiáng)化，60.0%(9/15)強(qiáng)化均勻； MRI檢查強(qiáng)化后64.3%(9/14)早期明顯強(qiáng)化，57.1% (8/14)信號(hào)均勻，35.7%(5/14)的病灶出現(xiàn)中央疤痕。本組行手術(shù)切除20例，1例未經(jīng)任何治療。結(jié)論FNH在臨床和影像學(xué)上均有一定特征，綜合分析臨床與多種影像學(xué)資料可提高正確診斷率。診斷FNH明確者不需外科治療。
引用本文： 王征旭,胡桂芳,吳孟超. 肝臟局灶性結(jié)節(jié)增生的診斷和治療(附21例報(bào)告). 中國(guó)普外基礎(chǔ)與臨床雜志, 2003, 10(2): 147-150. doi: 復(fù)制
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- 1. 吳孟超主編. 肝臟外科學(xué) [M]. 第2版. 上海: 上?？茖W(xué)技術(shù)文獻(xiàn)出版社，2000∶ 386~389.
- 2. Reddy KR， Kligerman S， Levi J， et al. Benign and solid tumors of the liver: relationship to sex, age, size of tumors, and outcome [J]. Am Surg, 2001; 67(2)∶173.
- 3. Kehagias D, Moulopoulos L, Antoniou A, et al. Focal nodular hyperplasia: imaging findings [J]. Eur Radiol, 2001; 11(2)∶202.
- 4. Bartolozzi C, Lencioni R, Paolicchi A, et al. Differentiation of hepatocellular adenoma and focal nodular hyperplasia of the liver: comparison of power Doppler imaging and conventional color Doppler sonography [J]. Eur Radiol，1997; 7(9)∶1410.
- 5. Colle I, de Beeck BO, Hoorens A, et al. Multiple focal nodular hyperplasia [J]. J Gastroenterol，1998; 33(6)∶904.
- 6. Schlott T，Ahrens K， Ruschenburg I， et al. Different gene expression of MDM2, GAGE1, 2 and FHIT in hepatocellular carcinoma and focal nodular hyperplasia [J]. Br J Cancer, 1999; 80(1-2)∶ 73.
- 7. Wang LY, Wang JH, Lin ZY, et al. Hepatic focal nodular hyperplasia: findings on color Doppler ultrasound [J]. Abdom Imaging, 1997; 22(2)∶178.
- 8. Mortele KJ, Stubbe J, Praet M, et al. Intratumoral steatosis in focal nodular hyperplasia coinciding with diffuse hepatic steatosis: CT and MRI findings with histologic correlation [J]. Abdom Imaging, 2000; 25(2)∶179.
- 9. Kacl GM, Hagspiel KD, Marincek B. Focal nodular hyperplasia of the liver: serial MRI with GdDOTA, superparamagnetic iron oxide, and GdEOBDTPA [J]. Abdom Imaging, 1997; 22(3)∶264.
- 10. Herman P, Pugliese V, Machado MA, et al. Hepatic Adenoma and focal nodular hyperplasia: differential diagnosis and treatment [J]. World J Surg, 2000; 24(3)∶ 372.