CT value in diagnosis and surgical treatment of focal fodular hyperplasia of the liver

Objective: To assess CT value in diagnosis and surgical indications of focal nodular hyperplasia(FNH) of liver.Methods: 23 cases with FNH treated in our department in the past 5 years(2002～2007) were studied retrospectively,all of them were examined with CT and blood tests and proved to be FNH by pathology.Results: All patients had a solitary globular,lobulated mass.On unenhanced CT,focal nodular hyperplasia is classically seen as asolitary,homogeneous,and slightly hypoattenuating area comparedwith normal liver,FNH demonstrated intense homogeneous enhancement during the arterial phase of enhanced imaging and 18 cases demonstrated hypert tenuating,5 cases demonstrated hypoattenuatingor isoattenuating area compared with normal liver during the later phase of enhanced imaging and venousphase.17 cases showed enhancement of the central scar during delayed phases,16 cases showed delayed enhancement at histologic analysis,16 cases of FNH were well limited but nonencapsulated.The hyperplastic parenchymaof the live was subdivided into small nodules that were surrounded by the fibrous septa,there was a central scar composed of fibrous connective tissue and malformed vessels of various caliber.16 cases underwent resection and nopostoperative complicationoccurred and 7 cases was established by needle biospy.Conclusion: The typical FNH can be diagnosed.Atypical cases should be differentiated from hepatocelluar adenoma hepatocellular carcinoma and hemangiomas.Asymptomatic FNH need no operation,but surgical resection is peroformed in the following conditions:diameter of the nodulus is beyond 5cm and with symptome,portal vein or inferior vena cava oppressed by the mass.