Diagnosis and treatment of hepatic focal nodular hyperplasia: report of 114 cases / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the diagnosis and treatment of the hepatic focal nodular hyperplasia (FNH).</p><p><b>METHODS</b>The clinical data of 114 patients with FNH proved by the pathology were analyzed retrospectively.</p><p><b>RESULTS</b>FNH occurs as a single node in 98.1%, ranging from 0.9 cm to 15.0 cm in diameter [average, (4.2 +/- 2.2) cm], only 2 patients had more than one FNH nodules. 86.0% of patients with FNH were below 50 years old. 89.5% of patients were asymptomatic. AFP was negative in all patients. Hepatitis B was negative in 4.4% (5/114) of patients. Of these patients, 50 lesions were in the left lobe, 50 in the right lobe, 6 in the mid lobe, and 8 in the caudate lobe. A big central artery was found in 3.5% (4/113) of the lesion in patients by color Doppler ultrasound. CT scan showed transient immediate enhancement in 94.3% (66/70) of patients, with central scar in 10 cases. The demonstration of a central scar in the lesion was very helpful for the diagnosis of FNH. MRI demonstrated early vigorous enhancement in 91.8% (56/61) of patients. It is strong enhancement on arterial phase and slight or obvious enhancement on portal venous phase and slightly delayed enhancement of the central scars in FNH. Eleven cases showed central scar. MRI was more helpful for the diagnosis of FNH using liver specific contrast agents superparamagnetic iron oxide (SPIO). All patients underwent focus resection, and there was no mortality and severe complication.</p><p><b>CONCLUSION</b>FNH shows some typical clinical and imaging features. We could improve the correct diagnosis rate by comprehensively analyzing the clinical and imaging materials.</p>