胰腺神经内分泌肿瘤的影像学表现与临床病理对照分析  

Neuroendocrine Tumors of the Pancreas:Imaging Findings and Clinic Pathology Correlation

作　　者：史玉振[1] 王中秋[1] 卢光明[1] 吴江[1] 朱庆强[1] 童明敏[1] 

机构地区：[1]南京军区南京总医院医学影像科,210002

出　　处：《临床放射学杂志》2011年第11期1618-1623,共6页Journal of Clinical Radiology

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

摘　　要：目的探讨胰腺神经内分泌肿瘤(NETP)的影像学特征,以提高对其诊断水平。资料与方法回顾性分析26例经手术病理证实的NETP的CT和(或)MRI表现,并和临床及病理作对照分析。结果 10例功能性NETP平均大小1.5cm×1.5cm×1.5cm,平扫呈等密度6例,稍低密度4例,1例瘤内见钙化,2例MRI呈长T1、长T2信号;16例非功能性NETP平均大小5.7cm×6.0cm×6.5cm,平扫呈实性3例,囊实性11例,囊性2例,3例瘤内见钙化,实性成分呈等密度或稍低密度,囊性坏死部分近似水样密度或信号,4例MRI扫描T1WI呈低信号,T2WI呈稍高信号(2例)或高信号(2例)。增强扫描动脉期功能性NETP呈中到明显强化10例,其中均匀强化占7例,非功能性NETP中到明显强化14例,其中不均匀强化9例。20例有完整或部分包膜,15例包膜明显强化呈环形。26例NETP中恶性12例(功能性1例,非功能性11例),其中侵犯血管、胰胆管各4例,浸润十二指肠9例,浸润肠系膜及大网膜、侵犯腹膜后神经各1例,淋巴结转移4例。与手术病理对照,术前影像诊断符合率为73%(19/26)。结论 NETP增强扫描呈中度到明显强化、包膜环形强化是其特征;邻近血管侵犯、局部浸润及淋巴结转移等征象进一步提示恶性NETP。影像学检查对NETP术前诊断具有较高价值。Objective To investigate the imaging features of neuroendocrine tumors of the pancreas（NETP）,so as to improve its diagnostic accuracy.Materials and Methods The CT and（or） MRI manifestations of 26 patients with NETP confirmed by pathology were analyzed retrospectively,and also compared with clinical and pathological results.Results The average size of 10 functional NETP was 1.5 cm×1.5 cm×1.5 cm.On CT plain imaging,the tumors showed isodensity in 6 cases,mild hypodensity in 4 and calcification in 1,respectively.MRI showed 2 cases with hypointensity on T1WI and hyperintensity on T2WI.The average size of 16 nonfunctional NETP was 5.7 cm×6.0 cm×6.5 cm.Of the 16 tumors,plain scan detected 3 solid masses,11 cystic solid masses and 2 cystic masses.Among them,3 tumors had calcification.The solid components showed isodensity or slightly hypodensity,while the cystic and necrotic was similar to water density or signal.MRI showed 4 tumors with hypointensity on T1WI,but 2 cases with hyperintensity and 2 cases with slightly hyperintensity on T2WI.On arterial phase scanning,10 functional NETP showed moderate to marked enhancement,in which 7 were homogenous.While 14 nonfunctional NETP showed moderate to marked enhancement,in which 9 were heterogeneous.20 NETP had complete or partial capsule,of which 15 cases showed marked enhanced ring shape.Of the 26 cases,12 malignant NETP（1 functional,11 nonfunctional） appeared vessels invasion and pancreaticobiliary duct invasion in 4 cases respectively,duodenum invasion in 9,mesentery and omentum invasion and retroperitoneal nerve invasion in 1 respectively,lymph node metastasis in 4.Compare to operation and pathology,the accuracy rates of preoperative diagnosis by imaging was 73%（19/26）.Conclusion NETP are characterized by moderate to marked enhancement with capsule marked ring-like enhancement during contrast scanning.The peripancreatic vessels invasion,local invasion and lymphnode metastasis are suggestive of malignant NETP.The imaging examination has an important valu

关 键 词：胰腺 神经内分泌肿瘤 磁共振成像 体层摄影术 X线计算机 

分 类 号：R735.9[医药卫生—肿瘤]