胰腺神经内分泌肿瘤的不典型影像表现与病理对照  

Pancreatic neuroendocrine tumors：comparison of the atypical imaging findings and the pathology

作　　者：张玉婷[1] 周俊林[1] 韩引萍 张学凌[1] 

机构地区：[1]兰州大学第二医院放射科,甘肃兰州730000

出　　处：《实用放射学杂志》2016年第5期729-732,741,共5页Journal of Practical Radiology

摘　　要：目的：分析胰腺神经内分泌肿瘤（PanNETs）的不典型CT、MRI表现，提高诊断率。方法回顾性分析6例经病理证实的PanNETs患者的临床、影像及病理资料。结果6例患者中，病变位于胰头部2例，胰体部3例，胰尾部1例；包括功能性PanNETs 2例，平均大小为2．1 cm ×2．6 cm ，瘤体密度或信号均较均匀；非功能性PanNETs 4例，平均大小为2．7 cm ×4．3 cm ，有1例瘤体内见钙化，2例发生明显囊变，其中1例囊内见出血信号；增强扫描6例病变均呈轻‐中度强化，3例肿瘤在动脉期及门静脉期呈持续性强化，延迟期对比剂退出，其中1例见完整的包膜环形强化，另外有2例呈渐进性强化，1例填充式强化；3例病变边界欠清，其中1例见脾静脉受侵；2例出现胆总管或胰管轻度扩张。结论 PanNETs可表现为明显囊变和（或）轻‐中度强化等不典型征象，认识其不典型影像表现有助于提高对其诊断准确率。Objective To investigate the atypical CT ,MRI findings of pancreatic neuroendocrine tumors （PanNETs） ,in order to improve diagnosis .Methods The clinical ,imaging and pathological data of 6 patients with PanNETs confirmed by pathology were analyzed retrospectively .Results In all 6 cases ,2 lesions were located in the pancreatic head ,3 lesions in the pancreatic body ,and 1 lesion in the pancreatic tail .There were 2 functional PanNETs with an average size of 2 .1 cm × 2 .6 cm ,which showed homogeneous density or signal .There were 4 nonfunctional PanNETs with an average size of 2 .7 cm × 4 .3 cm ,one of which had calcification ,and two of which had obviously cystic change ,including intracapsular bleeding in one case .Contrast‐enhanced examinations showed that all 6 lesions had mild or moderate enhancement .Three lesions were manifested as relatively intense enhancement in the arterial and portal venous phase ,but decreased enhancement in the delayed phase ,including annular envelope enhancement in one case .Two le‐sions were manifested as progressive enhancement .The last case was manifested as inwardly filled enhancement .Three lesions had unclear boundaries ,while one lesion had splenic vein invasion .Two cases accompanied with mild expansion of the common bile duct or pancreatic duct .Conclusion PanNETs can be ma＋nifested as atypical findings such as obviously cystic changes ,and（or） mild to moderate enhancement .It is suggested that the atypical imaging findings of PanNETs should be recognized well to improve the diag‐nostic accuracy .

关 键 词：胰腺神经内分泌肿瘤 磁共振成像 计算机体层成像 

分 类 号：R735.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]