非功能性胰神经内分泌肿瘤的螺旋CT诊断  

Spinal CT diagnosis of non-functioning neuroendocrine tumors of the pancreas

作　　者：史玉振[1] 王中秋[1] 杨帆[2] 童明敏[1] 

机构地区：[1]南京军区南京总医院医学影像科,南京210002 [2]南京军区南京总医院医学普外科,南京210002

出　　处：《医学研究生学报》2011年第11期1138-1142,共5页Journal of Medical Postgraduates

基　　金：国家自然科学基金(81071195);南京军区医药卫生科研基金(08MA087)

摘　　要：目的非功能性胰神经内分泌肿瘤(nonfunctioning neuroendocyine tumors of the pancreas,NFNTP)属于胰腺罕见肿瘤,文中探讨其螺旋CT多期扫描的表现,以提高此病诊断的正确性。方法回顾性分析16例经手术病理证实的NFNTP的螺旋CT多期扫描表现。螺旋CT采用平扫和三期动态增强扫描(动脉期、门脉期和延迟期),三期扫描时间分别为25、65和180s。结果 16例NFNTP平均大小5.7 cm×6.0 cm×6.5 cm,其中位于胰头12例,胰体2例,胰尾2例。平扫呈实性2例,囊实性11例,囊性3例,实性成分呈等或稍低密度,囊性坏死部分近似水样密度,3例肿瘤内见钙化。增强扫描动脉期肿瘤呈中度至明显强化15例,均匀强化2例,不均匀强化11例、环状强化3例;门脉期和延迟期11例强化有所下降,3例呈持续强化,2例呈渐进性强化,2例呈向心性填充式强化;增强扫描12例边界清晰,可见包膜,其中10例肿瘤包膜明显强化,呈高密度环形薄壁,4例境界不清。12例胰头肿瘤中,4例胆管扩张;3例胰管扩张,1例胰尾萎缩,4例胰腺周围血管受侵犯。结论NFNTP螺旋CT动态增强扫描具有境界清晰、中到明显强化和瘤周环形薄壁(包膜)明显强化的特征,同时具有较少侵犯胰胆管及邻近血管的特点。] Objective Nonfunctioning neuroendocrine tumors of the pancreas(NFNTP) are extremely rare.This study aimed to investigate the enhanced multi-phase spiral CT features of NFNTP,so as to improve its diagnosis.Methods We retrospectively analyzed the spiral CT findings of 16 cases of surgically and pathologically confirmed NFNTP using precontrast and contrast scanning(including arterial,portal venous and delayed phases).The contrast scanning started in 25s,65s and 180s after injection of the contrast medium.Results The average size of 16 tumors was 5.7 cm×6.0 cm×6.5 cm.Twelve of them were localized in the pancreatic head,2 in the body,and 2 in the tail.Plain scanning detected 2 solid masses,11 cystic-solid masses and 3 cystic masses.The solid components showed mostly isodensity or slightly low density,while the cystic and necrotic were similar to water density.Three of the tumors exhibited calcification.Lesions with moderate to marked enhancement counted up to 15 cases on arterial phase scanning.There were 2 cases with homogenous enhancement,11 heterogenous enhancement and 3 ring enhancement.On the portal venous and delayed phase,the intensity of 11 tumors declined,3 manifested continuous enhancement,2 delayed enhancement,and 2 centripetal filling enhancement.Twelve cases displayed clear border and visible capsule,and 4 unclear.The capsules of 10 tumors were enhanced markedly,with thin rings.Of the 12 tumors in the pancreatic head,dilated bile duct was found in 4,dilated pancreatic duct in 3,atrophy of the pancreas in 1,and peripancreatic vessel invasion in 4.Conclusion NFNTP is characterized by clear border,moderate to marked enhancement and peritumor thin wall(capsule) marked enhancement during dynamic contrast scanning.Meanwhile,it is less likely to invade the bile duct,pancreatic duct,and peripancreatic vessels.

关 键 词：胰腺 神经内分泌肿瘤 体层摄影术 X线计算机 

分 类 号：R736[医药卫生—肿瘤]