前列腺原发神经内分泌癌的CT、MR诊断  

CT and MR diagnosis of primary prostatic neuroendocrine carcinoma

作　　者：何海青[1] 樊树峰[1] 陈邦文[1] 杨爱春[1] 李扬飞[1] 

机构地区：[1]浙江省台州医院放射科,浙江台州317000

出　　处：《医学影像学杂志》2013年第1期107-109,共3页Journal of Medical Imaging

摘　　要：目的探讨前列腺原发神经内分泌癌CT、MR表现特点。方法回顾性分析经手术病理证实的前列腺神经内分泌癌病例5例,年龄68～78岁。临床症状主要是排尿不畅、尿频、血尿。结果本组前列腺神经内分泌癌瘤灶均呈不规则形,体积较大,无钙化灶,增强后不均匀强化。MRI表现为T1WI等信号,T2WI混杂高信号,DWI稍高信号,ADC值约为(0.8～1.0)×10-3 mm2/s,增强后不均匀强化。5例中2例侵犯膀胱,1例侵犯直肠,骨转移4例,肾上腺转移1例,肺部转移3例,肝转移3例,盆腔、髂窝淋巴结转移3例。免疫组化NSE、Cga、Syn检查有阳性表达。结论前列腺神经内分泌癌CT、MR表现为瘤灶较大,形态不规则,常侵犯邻近组织,常伴有远处转移(特别是骨外转移),PSA水平升高不显著。NSE、Cga、Syn的阳性表达对本病的确诊有决定性意义。Objective To observe imaging feature of the primary prostatic neuroendocrine carcinoma. Methods Five patients with primary prostatic neuroendocrine carcinoma proven pathologically were retrospectively analyzed, their ages were between 68 to 78 years old. Their clinical symptoms included urination unfreely, frequent micturition, and blood urine. Results The features of primary prostatic neuroendocrine carcinoma in CT included Iirregular shape, large mass, no calcification, inhomogeneous enhancement. The vicinity organizes invasion and the distance metastasis were usually observed. MR appearance included equal signals in T1WI, miscellaneous high signal in T2WI, high signal in DWI, and the mean ADCs for the carcinoma focus were （0. 8～ 1.0） × 10^-3 mm^2/s. Chromogranin A（CgA）, neuron-specific eno-lase （NSE）, and synaptophysin （SYN） had different levels of expression in the five cases. Conclusion CT and MR can show some characteristic features of primary prostatic neuroendocrine carcinoma, such as large mass, irregular shape, invading the vicinity organ, and metastasis often happened in the distance organizes, especially in the organs out of bone, and the level of PSA is not risen obviously. CgA, NSE, SYN have different levels of expression, which was consistent with prostatic neuroendocrine carcinoma diagnosis.

关 键 词：前列腺 神经内分泌癌 影像诊断 

分 类 号：R737.25[医药卫生—肿瘤] R445[医药卫生—临床医学]