胰腺神经内分泌肿瘤的MRI征象及与病理分级的对照研究  

MRI appearance of pancreatic neuroendocrine neoplasms correlation with pathological grade： comparative study

作　　者：王明亮[1] 纪元[2] 谢艳红[2] 饶圣祥[1] 陈财忠[1] 张澍杰[1] 曾蒙苏[1] 

机构地区：[1]复旦大学附属中山医院放射科上海市影像医学研究所 复旦大学上海医学院影像学系,200032 [2]复旦大学附属中山医院病理科

出　　处：《中华放射学杂志》2017年第2期136-140,共5页Chinese Journal of Radiology

摘　　要：目的探讨胰腺神经内分泌肿瘤（pNEN）的MRI特征及预测病理分级的价值。方法回顾性分析经手术病理确诊为胰腺pNEN，术前均进行过上腹部MRI检查且临床、影像和病理资料完整的35例患者。所有患者均行上腹部MRI平扫和增强扫描。分析肿瘤的MRI表现，包括肿瘤部位、大小、形态、边缘、信号、强化特点、主胰管扩张、胰腺外组织侵犯、淋巴结转移及肝转移等。参照WHO2010消化系统肿瘤分级系统标准，将肿瘤的病理分级分为G1、G2、G3级。G1级和G2级间定量指标的比较采用独立样本t检验，定性指标的比较采用Fisher精确概率法。结果35例pNEN病灶均为单发，病理分级G1级14例、G2级19例、G3级2例。实性病变33个，囊性病变2个。G1与G2组患者的性别差异有统计学意义（P〈0．05），内分泌功能和年龄差异无统计学意义（P〉0．05）。35个病灶类圆形病灶为27个，不规则形8个；边缘清晰18个，边缘模糊17例；3个病灶（G2级1个、G3级2个）可见主胰管轻度扩张。G1与G2级病灶的直径、形状、边缘、胰腺外侵犯、转移、平扫信号均质程度差异有统计学意义（P〈0．05），主胰管扩张及增强扫描所有期相的信号强度差异无统计学意义（P〉0．05）。G3组2个病灶增强后表现为轻度强化，强化程度始终低于胰腺组织。结论pNEN的MRI表现具有一定特征，肿瘤大小、形状、边缘、信号均质程度、胰腺外侵犯和转移等可以在术前预测pNEN的病理分级。Objective To analyze MR imaging appearance of pancreatic neuroendocrine neoplasms （pNEN） and to investigate the practical value of MR imaging appearance in predicting pathological grade of pNEN. Methods All data of 35 patients with pathologically proven pNEN were retrospectively reviewed. MR examinations of the abdomen were performed on all these patients before operation and the data of clinical, pathological and MR imaging were intact. Both plain scan and contrast-enhanced MR scan were performed on each patient. Histopathological grade of pNEN was defined as： G1, G2, and G3 according to World Health Organization classification of tumours of the digestive system guidelines （2010）. Image analysis included tumor location, number, size, shape, lesion margins, signal intensity, enhancement pattern, main pancreatic duct dilatation, extrapancreatic spread, and metastases of lymph node and liver. The comparison of quantitative index between G1 and G2 group was performed witb t test. Categorical variables were tested using Fisher exact test. Results Thirty five lesions were found in 35 patients, with 14 lesions in G1, 19 lesions in G2, and 2 lesions in G3.Thirty three lesions appeared as a solid mass, and 2 lesions appeared as a cystic lesion. Significant gender-based difference was found between G1 group and G2 group （P〈0.05）. No significant age-based or endocrine function difference was found between the G1 group and G2 group（P〉0.05）. Of the 35 lesions, 27 lesions were round in shape, while other 8 lesions were irregular. There were 18 lesions with clear margin, and the margins in other 17 lesions were blurred. Main pancreatic duct dilatation was found in 3 cases （1 in G2, 2 in G3）. Significant differences in tumor diameter, shape, margin, signal intensity on precontrast images, extrapancreatic spread and metastases were found between G 1 group and G2 group （P〈0.05）. No significant difference was found in main pancreatic duct dilatation or signal intensity on all enhancement phases betw

关 键 词：胰腺肿瘤 神经内分泌肿瘤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.9[医药卫生—诊断学]