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目的总结肝脏局灶性结节增生的临床表现、影像学特点及治疗方法。方法从北京大学人民医院病案数据库中检索2007年1月至2016年12月期间接受肝脏手术患者的临床病理资料,选取经病理证实存在肝脏局灶性结节增生的病例进行回顾性分析,分析肝脏局灶性结节增生患者的临床特点及各种影像学检查方法的正确诊断率。结果共有22例经病理检查证实为肝脏局灶性结节增生的患者纳入了本研究,其中男10例,女12例。年龄20~61岁,(36.8±11.2)岁,>50岁者有3例。18例患者为体检时发现,3例因右上腹胀痛就诊,1例因甲胎蛋白轻度升高检查发现。3例患者在观察过程中出现病灶明显增大。17例患者做了腹部增强CT,准确诊断为肝脏局灶性结节增生者11例(64.70%);19例做了MRI检查,准确诊断为肝脏局灶性结节增生者16例(84.21%)。2例病灶位于肝脏尾叶,9例位于左肝,11例位于右肝。病灶最大径线为1.0~7.8 cm,(4.16±1.92)cm,最大径线>5.0 cm者有9例。所有患者在接受肝部分切除手术治疗后均顺利恢复,未出现严重并发症。随访1~103个月,未见肝脏局灶性结节增生复发。结论肝脏局灶性结节增生多见于年轻患者,常为体检时发现,MRI扫描具有较好的诊断价值。
Objective To summarize the clinical manifestations, imaging features and treatment of hepatic focal nodular hyperplasia. Methods The clinical and pathological data of patients undergoing liver surgery from January 2007 to December 2016 were retrieved from the record database of Peking University People’s Hospital. Retrospective analysis was made on the pathologically confirmed cases of hepatic focal nodular hyperplasia. The liver The clinical features of patients with focal nodular hyperplasia and the correct diagnostic rate of various imaging methods. Results A total of 22 patients with pathologically confirmed liver nodular hyperplasia were enrolled in this study, including 10 males and 12 females. Age 20 to 61 years old, (36.8 ± 11.2) years old,> 50 years old in 3 cases. 18 patients were found during physical examination, 3 cases of pain due to pain in the right upper quadrant, 1 case of mildly elevated alpha-fetoprotein examination found. Three patients in the observation process lesions significantly increased. Eleven patients (64.70%) had focal abdominal nodular hyperplasia diagnosed correctly in 17 patients. MRI was performed in 19 patients and 16 (84.21%) were correctly diagnosed as hepatic focal nodular hyperplasia ). Two lesions were located in the caudate lobe, nine in the left liver and 11 in the right liver. The largest diameter of the lesions was 1.0 ~ 7.8 cm, (4.16 ± 1.92) cm, the largest diameter of> 5.0 cm in 9 cases. All patients underwent partial hepatectomy after the successful recovery, no serious complications. Follow-up 1 ~ 103 months, no recurrence of focal liver nodules hyperplasia. Conclusion Focal nodular hyperplasia of liver is more common in young patients. It is often found during physical examination that MRI scan has a good diagnostic value.