Improvement of clinical diagnosis and management of hepatic FNH——an analysis of 74 cases

Objective To explore the current problem in diagnosis of hepatic focal nodular hyperplasia（FNH） and possible improvement strategies.Methods Clinical data were collected from FNH patients from May 2012 to December2018,where the patients were pathologically diagnosed,with one or more liver CT and MRI plain and enhancement scanning or contrast-enhanced ultrasound that were consistent with hepatic FH1.Their clinical diagnostic features and treatment strategies were summarized.Results A total of 74 cases were screened out,including 66.22%（49 cases） were men and only 1 woman with a history of taking birth control pills.There were 68.92% patients（51 cases） within a range of 16-35 years,and 91.89%（68 patients）presented no symptoms.The positive diagnosis rate of FNH was 36.49%for B-ultrasound,57.47% for CT,55.81% for MRI,80.77% for combined use of MRI and CT,and above 80% for other combined uses.The clinical diagnosis rate was 68.92%（51 cases）.In light of retrospective analysis of FNH characteristics,the CT and MRI corrected positive rates were 80.85%（χ²=6.034,P＜0.05） and 88.37%（χ²=11.328,P＜0.01）,respectively;and the positive rate of corrected clinical diagnosis reached 87.84%（65 cases）（χ²=7.815,P＜0.01）,which were statistically significant compared with those before correction.With respect to patient age（＜35 years old）,without hepatitis,cirrhosis and normal tumor markers and liver function,the diagnosis rate of hepatic FNH was 93.24%（69 cases）.Conclusions Good clinical diagnosis of hepatic FNH can be achieved through enhancing the comprehensive understanding of clinicians towards hepatic FNH,basically considering image characteristics in addition to patient age,normal tumor markers and liver function,without hepatitis and cirrhosis,and combined imaging examinations when necessary,so as to greatly improve hepatic FNH diagnosis and treatment.