首页|Hepatic focal nodular hyperplasia in children: Imaging features on multi-slice computed tomography

Hepatic focal nodular hyperplasia in children: Imaging features on multi-slice computed tomography

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AIM:To retrospectively analyze the imaging features of hepatic focal nodular hyperplasia (FNH) in children on dynamic contrast-enhanced multi-slice computed tomography (MSCT) and computed tomography angiography (CTA) images.METHODS:From September 1999 to April 2012,a total of 218 cases of hepatic FNH were confirmed by either surgical resection or biopsy in the Sun Yat-sen Memorial Hospital of Sun Yat-sen University and the Cancer center of Sun Yat-sen University,including 12 cases (5.5％) of FNH in children (age ≤ 18 years old).All the 12 pediatric patients underwent MSCT.We retrospectively analyzed the imaging features of FNH lesions,including the number,location,size,margin,density of FNH demonstrated on pre-contrast and contrastenhanced computed tomography (CT) scanning,central scar,fibrous sepia,pseudocapsule,the morphology of the feeding arteries and the presence of draining vessels (portal vein or hepatic vein).RESULTS:All the 12 pediatric cases of FNH had solitary lesion.The maximum diameter of the lesions was 4.0-12.9 cm,with an average diameter of 5.5 ± 2.5 cm.The majority of the FNH lesions (10/12,83.3％) had well-defined margins.Central scar (10/12,83.3％) and fibrous septa (11/12,91.7％) were commonly found in children with FNH.Central scar was either isodense (n =7) or hypodense (n =3) on pre-contrast CT images and showed progressive enhancement in 8 cases in the equilibrium phase.Fibrous septa were linear hypodense areas in the arterial phase and isodense in the portal and equilibrium phases.Pseudocapsule was very rare (1/12,8.3％) in pediatric FNH.With the exception of central scars and fibrous septa within the lesions,all 12 cases of pediatric FNH were homogenously enhanced on the contrast-enhanced CT images,significantly hyperdense in the arterial phase (12/12,100.0％),and isodense in the portal venous phase (7/12,58.3％) and equilibrium phase (11/12,91.7％).Central feeding arteries inside the tumors were observed on CTA images for all 12 cases of FNH,whereas no neovascularization of malignant tumors was noted.In 9 cases (75.0％),there was a spoke-wheel shaped centrifugal blood supply inside the tumors.The draining hepatic vein was detected in 8 cases of pediatric FNH.However,the draining vessels in the other 4 cases could not be detected.No associated hepatic adenoma or hemangioma was observed in the livers of the 12 pediatric cases.CONCLUSION:The characteristic imaging appearances of MSCT and CTA may reflect the pathological and hemodynamic features of pediatric FNH.Dynamic multi-phase MSCT and CTA imaging is an effective method for diagnosing FNH in children.

Focal nodular hyperplasiaLiverChildrenBenign hepatic lesionsX-rayComputed tomography

Qing-Yu Liu、Wei-Dong Zhang、Dong-Ming Lai、Ying Ou-yang、Ming Gao、Xiao-Feng Lin

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Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University,Guangzhou 510120, Guangdong Province, China

Department of Radiology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province,China

Department of General Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120,Guangdong Province, China

Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China

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2012

10.3748/wjg.v18.i47.7048

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(47)
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