胰腺神经内分泌肿瘤的CT诊断  

CT diagnosis of neuroendocrine tumor of pancreas

作　　者：李冬成 杨莹 丁燕萍 唐建伟 刘希胜 祁良 王仁法[3] 

机构地区：[1]无锡市第九人民医院放射科,江苏214062 [2]南京医科大学第一附属医院医学影像科,南京210029 [3]华中科技大学附属同济医院放射科,武汉430030

出　　处：《放射学实践》2014年第12期1448-1451,共4页Radiologic Practice

摘　　要：目的:探讨胰腺神经内分泌肿瘤(NETP)的CT表现及其诊断价值。方法:回顾性分析经手术病理证实的28例NETP患者的临床和影像资料,运用Spearman等级相关分析比较不同级别肿瘤间的强化差异,运用Fisher精确检验法比较功能性和非功能性肿瘤间强化程度的差异。结果:28例中功能性NETP 5例,非功能NETP 23例;根据WHO分级,G1级15例,G2级9例,G3级4例;肿瘤以实性成份为主25例(8例为完全实性),囊性为主3例;18例肿瘤实性部分在增强扫描动脉期呈明显强化,其余10例肿瘤强化程度类似于胰腺或者略低于胰腺;增强扫描动脉期,15例G1级NETP中肿瘤实质部分明显强化13例,9例G2级肿瘤中明显强化4例;4例G3级肿瘤中仅1例表现为明显强化;增强扫描动脉期,5例功能性NETP中肿瘤实质部分明显强化3例,23例非功能性NETP中15例明显强化;肿瘤病理分级越高,表现为明显强化的可能性越小(rs=-0.752,P<0.05),功能性和非功能性肿瘤间的强化差异无统计学意义(P=0.601>0.05)。结论:NETP的CT表现具有一定的特征性,CT有助于肿瘤的术前评价,指导临床制订治疗方案。Objectire：To analyze the CT manifestations of neuroendocrine tumor of pancreas （NETP）and the diag-nostic value of CT.Methods：The CT images and clinical data of 28 patients with NETP proved by surgery and pathology were retrospectively analyzed by two radiologists.All the tumors were graded as G1 to G3 according to the WHO classifica-tion in 2010.Spearman′s rank correlation analysis was performed to compare enhancement degree with pathological grade of NETP,Fisher＆#39;s exact test was used to analyze the difference of enhancement degree between functional and non-functional NETP.Results：Of all 28 cases,there were functional NETPs in 5 cases,and non-functional NETPs in 23 cases.The tumors of 15 cases were graded as G1,9 cases as G2,and 4 cases as G3.Most of the tumors consisted of solid and cystic compo-nents,most of the components were solid in 25 cases （the tumor was completely solid in 8 cases）,or cystic in 3 cases.After contrast-enhancement,the solid parts of tumor showed obvious enhancement in 18 cases,showed mild enhancement similar to that of normal pancreatic parenchyma in 10 cases.In arterial phase of contrast enhanced scan,13 of 14 G1-NETPs showed obvious enhancement,4 of 9 G2-tumors showed obvious enhancement,1 of 4 G3-tumors showed obvious enhancement.3 of 5 functional NETPs showed obvious enhancement,15 of 23 non-functional tumors showed obvious enhancement.The en-hancement of tumors with higher grade showed a probable trend of decrease （γs=-0.752,P〈0.05）,there was no statistic difference in enhancement between functional and non-functional tumors （P =0.601＆gt;0.05）.Conclusion：NETPs have some characteristic CT features which can be helpful to evaluate the malignant degree of tumor before operation,and provide more information for the postoperative treatment planning.

关 键 词：胰腺肿瘤 体层摄影术 X 线计算机 神经内分泌肿瘤 病理学 

分 类 号：R730.44[医药卫生—肿瘤] R735.9[医药卫生—临床医学]