多层螺旋CT对无功能性胰岛细胞瘤与胰腺癌的鉴别  

Non-functional Islet Cell Tumor: Differentiation from Pancreatic Cancer at MSCT

作　　者：赵德利[1] 张在人[1] 刘白鹭[1] 张金玲[1] 

机构地区：[1]哈尔滨医科大学第二临床医学院CT室,黑龙江哈尔滨150086

出　　处：《黑龙江医学》2004年第9期657-658,共2页Heilongjiang Medical Journal

摘　　要：目的　比较多层CT胰岛细胞瘤 (NFIT)与胰腺癌 (PC)影像表现 ,阐述胰岛细胞瘤的多层CT(MSCT)影像学特点。方法　 18例患者中 ,4例为无功能性胰岛细胞瘤 (平均直径为 5 8mm ,大小范围在 3 5～11 5cm) ,14例胰腺癌 (平均直径为 5 1cm ,大小范围为 3 2～ 10 5cm)。由 3个影像医师对 18例患者的平扫(边缘、肿瘤内坏死、周围结构 )及增强 (动脉期、胰腺期、肝脏期 ,实胰腺期和肝脏期的衰减情况 )MSCT影像学特征进行回顾性分析。结果　平扫 :4例无功能性胰岛细胞瘤中 ,边缘光滑 1例 (2 5 % ) ,胰腺癌边缘光滑 2例 (14 3% ) ;肿瘤内有坏死的无功能性胰岛细胞瘤 1例 (2 5 % ) ,胰腺癌 9例 (6 4% ) ;浸及周围结构 :4例无功能性胰岛细胞瘤中无 1例累及邻近动脉 ,而 14例胰腺癌累及肠系膜动脉的占 6例。增强 :4例NIC中 2例呈不均匀强化 ,2例动脉期和胰腺期明显高于胰腺实质 ,3例胰腺期与肝脏期的衰减范围是 1～ 10HU ;14例胰腺癌中 ,12例动脉期和胰腺期轻度不均匀强化 ,低于正常胰腺组织 ,2例胰腺癌肿块动脉期略高于正常胰腺组织 ;14例中 8例胰腺期与肝脏期肿瘤衰减范围 >10HU。结论　MSCT在鉴别胰岛细胞瘤与胰腺癌时有重要的意义 。Objective To compare various multislice computed tomographic non-functional islet cell tumor (NFIT) with those of pancreatic cancer (PC) with the aim of demonstrating the imaging features. Methods 18 patients 94 with NFIT of pancreas mean diameter 5.8 cm ranged from 3.5～11.5 cm) and 14 with PC (mean diameter 5.1 cm ranged from 3.2～10.5 cm) who had undergone MSCT with enhanced and unenhanced scanning were evaluated. Three reviewer who were unaware of the diagnosis retrospectively recorded tumor characteristics enhanced and unenhanced scans. (ie. homogeneity of enhancement, amount of enhancement, tumor margin, intratumoral necrosis, peripheral changes). Results The tumor margin was smooth on unenhanced scans, both in patients with NFIT and in patients with PC. The intratumor necrosis was demonstrated in 1 of the NFIT and 9 of PC, and peripheral change (ie, enhancment of the superior mesenteric artery 6 in PC). The tumor showed heterogenous enhancement an arterial phase, both in patients with NFIT and PC. Tumor attention was higher than that of surrounding pancreatic parenchyma on arterial phase. Among the 4 cases of NFIT, 3 cases showed tumor the attenuation between parenchyma and hepatic phases ranged from 1hu to 10 hu. Among the 14 cases of PC, 8 cases the attenuation was large for 10 between parenchyma and hepatic phases. Conclusion MSCT may be useful in differentiating NFIT of PC with characteristics of unenhanced and the pattern of enhancement being the most valuable MSCT findings.

关 键 词：医学影像学 体层摄影术 X线计算机 无功能性 胰岛细胞瘤 胰腺癌 

分 类 号：R814.42[医药卫生—影像医学与核医学]