肝硬化背景下肝脏局灶性结节增生的影像学特点3例报告

李梓楠; 唐少珊; 吴星霓; 李想

doi:10.3969/j.issn.1001-5256.2023.01.021

肝硬化背景下肝脏局灶性结节增生的影像学特点3例报告

DOI: 10.3969/j.issn.1001-5256.2023.01.021

中国医科大学附属盛京医院超声科，沈阳 110004

基金项目:

辽宁省民生科技计划联合计划项目 (2021JH2/10300114)

伦理学声明：本例报告已获得患者/患者家属知情同意。

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：李梓楠负责课题设计，资料分析，撰写论文；吴星霓、李想参与收集数据，修改论文；唐少珊负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
唐少珊，tangss@sj-hospital.org (ORCID：0000-0002-6020-991X)

计量
- 文章访问数: 1861
- HTML全文浏览量: 1496
- PDF下载量: 107
- 被引次数: 0
出版历程
- 收稿日期: 2022-04-22
- 录用日期: 2022-06-28
- 出版日期: 2023-01-20

Focal nodular hyperplasia-like nodules in liver cirrhosis: An imaging analysis of three cases

Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, China

Research funding:

Liaoning Province People's Livelihood Science and Technology Planning Joint Project (2021JH2/10300114)

More Information

Corresponding author: TANG Shaoshan, tangss@sj-hospital.org(ORCID: 0000-0002-6020-991X)

摘要

- 肝硬化 /
- 局限性结节状增生 /
- 癌, 肝细胞 /
- 诊断, 鉴别
- Liver Cirrhosis /
- Focal Nodular Hyperplasia /
- Carcinoma, Hepatocellular /
- Diagnosis, Differential

HTML全文

图 1 病例1影像学和病理结果

注：a，超声示S2段见低回声结节，边界不清(箭头)；b，超声造影示动脉相20 s病灶呈高增强(箭头)；c，超声造影示门脉相病灶呈等增强(箭头)；d，超声造影示延迟相病灶呈等增强(箭头)；e，增强CT示动脉相病灶明显强化；f，肝部分切除术后大体标本；g，术后病理HE染色(×100)。

Figure 1. Imaging and pathology of case 1

下载: 全尺寸图片幻灯片

图 2 病例2影像学和病理结果

注：a，超声示S5段见低回声结节，边界不清(箭头)；b，超声造影示动脉相造影剂填充，门静脉相38 s呈整体高增强(箭头)；c，超声造影示门静脉相1 min，病灶呈低增强(箭头)；d，超声造影示延迟相病灶呈明显低增强(箭头)；e，增强MRI示S5段动脉相病灶强化(箭头)；f，术后病理HE染色(×100)。

Figure 2. Imaging and pathology of case 2

下载: 全尺寸图片幻灯片

图 3 病例3影像学和病理结果

注：a，超声示肝左外叶S2段见低回声结节，边界清楚，CDFI检出血流信号(箭头)；b，超声造影示动脉相27 s病灶呈高增强(箭头)；c，超声造影示门静脉相病灶呈等增强(箭头)；d，超声造影示延迟相4 min 30 s病灶呈略低增强(箭头)；e，增强CT示S2段病灶动脉期不均匀强化(箭头)；f，增强MRI肝胆期示S2段病灶呈环状强化(箭头)；g，肝部分切除术后大体标本；h，术后病理HE染色(×100)。

Figure 3. Imaging and pathology of case 3

下载: 全尺寸图片幻灯片

参考文献(13)

[1]	VILGRAIN V, PARADIS V, van WETTERE M, et al. Benign and malignant hepatocellular lesions in patients with vascular liver diseases[J]. Abdom Radiol (NY), 2018, 43(8): 1968-1977. DOI: 10.1007/s00261-018-1502-7.
[2]	SUGIHARA S, NAKASHIMA O, KIYOMATSU K, et al. A case of liver cirrhosis with a hyperplastic nodular lesion[J]. Acta Pathol Jpn, 1990, 40(9): 699-703. DOI: 10.1111/j.1440-1827.1990.tb01619.x.
[3]	LIBBRECHT L, CASSIMAN D, VERSLYPE C, et al. Clinicopathological features of focal nodular hyperplasia-like nodules in 130 cirrhotic explant livers[J]. Am J Gastroenterol, 2006, 101(10): 2341-2346. DOI: 10.1111/j.1572-0241.2006.00783.x.
[4]	LIU KB, ZHAO P, YANG YC, et al. Features of hepatic focal nodular hyperplasia by contrast-enhanced ultrasound[J]. J Clin Med Imaging, 2021, 32(6): 423-425. DOI: 10.12117/jccmi.2021.06.011. 刘柯兵, 赵萍, 杨义春, 等. 肝脏局灶性结节增生的超声造影诊断表现[J]. 中国临床医学影像杂志, 2021, 32(6): 423-425. DOI: 10.12117/jccmi.2021.06.011.
[5]	SASAKI M, YONEDA N, SAWAI Y, et al. Clinicopathological characteristics of serum amyloid A-positive hepatocellular neoplasms/nodules arising in alcoholic cirrhosis[J]. Histopathology, 2015, 66(6): 836-845. DOI: 10.1111/his.12588.
[6]	KIM JH, JOO I, LEE JM. Atypical appearance of hepatocellular carcinoma and its mimickers: how to solve challenging cases using gadoxetic acid-enhanced liver magnetic resonance imaging[J]. Korean J Radiol, 2019, 20(7): 1019-1041. DOI: 10.3348/kjr.2018.0636.
[7]	LIU ZL, ZHANG C, YAN JP, et al. Diagnostic value of conventional ultrasound and contrast- enhanced ultrasound for focal nodular hyperplasia of the liver[J]. J Clin Hepatol, 2020, 36(9): 2056-2058. DOI: 10.3969/j.issn.1001-5256.2020.09.029. 刘志龙, 张超, 严继萍, 等. 常规超声及超声造影对肝局灶性结节性增生的诊断价值[J]. 临床肝胆病杂志, 2020, 36(9): 2056-2058. DOI: 10.3969/j.issn.1001-5256.2020.09.029.
[8]	TANG M, LI Y, LIN Z, et al. Hepatic nodules with arterial phase hyperenhancement and washout on enhanced computed tomography/magnetic resonance imaging: how to avoid pitfalls[J]. Abdom Radiol (NY), 2020, 45(11): 3730-3742. DOI: 10.1007/s00261-020-02560-0.
[9]	KIM MJ, LEE S, AN C. Problematic lesions in cirrhotic liver mimicking hepatocellular carcinoma[J]. Eur Radiol, 2019, 29(9): 5101-5110. DOI: 10.1007/s00330-019-06030-0.
[10]	KONO Y, LYSHCHIK A, COSGROVE D, et al. Contrast enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS^®): the official version by the American College of Radiology (ACR)[J]. Ultraschall Med, 2017, 38(1): 85-86. DOI: 10.1055/s-0042-124369.
[11]	TAN Y, TANG CL, CHEN P, et al. Value of contrast-enhanced ultrasound in diagnosis of hepatic focal nodular hyperplasia[J]. J Clin Ultrasound Med, 2019, 21(6): 410- 413. DOI: 10.3969/j.issn.1008-6978.2019.06.005. 谭鹰, 唐春霖, 陈萍, 等. 超声造影诊断肝脏局灶性结节状增生的应用价值[J]. 临床超声医学杂志, 2019, 21(6): 410-413. DOI: 10.3969/j.issn.1008-6978.2019.06.005.
[12]	KIM JW, LEE CH, KIM SB, et al. Washout appearance in Gd-EOB-DTPA-enhanced MR imaging: A differentiating feature between hepatocellular carcinoma with paradoxical uptake on the hepatobiliary phase and focal nodular hyperplasia-like nodules[J]. J Magn Reson Imaging, 2017, 45(6): 1599-1608. DOI: 10.1002/jmri.25493.
[13]	VERNUCCIO F, GAGLIANO DS, CANNELLA R, et al. Spectrum of liver lesions hyperintense on hepatobiliary phase: an approach by clinical setting[J]. Insights Imaging, 2021, 12(1): 8. DOI: 10.1186/s13244-020-00928-w.