胰腺神经内分泌肿瘤的MRI表现与病理分级的对照研究  

A comparative study on MRI appearance and pathological grading for pancreatic neuroendocrine tumors

作　　者：孙素[1] 杨爱春 付玉川[1] 严志汉[1] 赵晓君[1] Sun Su, Yang A ichun, Fu Yuchuan, Yah Zhihan, Zhao Xiaojun Department of Radiology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China(Sun S, Fu YC, Yah ZH, Zhao X J）; Department of Radiology, Taizhou Enze Medical Center, Zhejiang Taizhou Hospital, Linhai 2317000, China （ Y ang A C)

机构地区：[1]浙江省温州医科大学附属第二医院放射科,温州132500 [2]台州恩泽医疗中心(集团)浙江省台州医院放射科,临海231700

出　　处：《中华内分泌外科杂志》2017年第6期490-493,499,共5页Chinese Journal of Endocrine Surgery

基　　金：温州市科技局课题（2017Y0646）

摘　　要：目的探讨常规与功能磁共振成像参数在胰腺神经内分泌肿瘤（pNET）术前分级当中的价值。方法回顾性分析35例经手术病理证实的pNET的MRI资料，包括肿瘤大小、T1和T22WI信号强度、强化特点及ADC值等，参照2010年WHO最新分类方法，将肿瘤分为G1～G3三个等级。结果35例患者40个病灶，平均大小约为（4．2±2．9）cm，男性20例，女性15例；其中WHOG1～G3级肿瘤分别为18、12、10个。不同病理级别间肿瘤大小差异存在统计学意义（P〈0．05），肿瘤级别越高，肿瘤直径越大；T1及T2WI信号强度在预测肿瘤分级中无意义；强化特点在肿瘤分级之间差异具有统计学意义（P〈0．05）；功能参数ADC值随着肿瘤级别升高呈递降趋势（G1-G3）ADC值：（2．23±0．80）×10^-3、（1．80±0．73）×10^-3、（0．92±0．24）×10^-3mm2／s，且差异有统计学意义（P〈0．05）。结论磁共振成像的强化特点和功能参数ADC值有助于pNET的术前分级。Objective To explore the value of conventional and functional MRI image parameter in pre- operative grade of pancreatic neuroendocrine tumours （pNET）. Methods Data of 35 cases of pNET were retro- spectively analyzed, including tumor size, intensity of TIWI＇ s and T2WI＇ s signal, enhancement feature, and ap- parent diffusion coefficients （ADC）value. All kinds of tumors were classified into G1 to G3 according to WHO＇s classification in 2010. Results There were 40 pNETs （mean size （4.2±2.9）cm） among the 35 patients （20 male, and 15 female）. By WHO＇s tumor grading, the number of patients from G1 to G3 was 18（45%）, 12（30%）, and 10（25 %）,respectively. A higher grade was associated with larger tumor size（P〈0.05）. Intensity of T1WI and T2WI signal has no significance for predicting tumor grade. Enhancement feature had statistical significance on tumor＇s grade （P〈0.05） .ADC value decreased with the increase of tumor＇ s grade, （2.23±0.80） ×l0^-3, （ 1.80±0.73 ）×l0^-3, （0.92±0.24） ×l0^-3 mm^2/s respectively for tumors from grade G1 to G3. Conclusion Enhancement features of MRI image and ADC value are conducive to preoperative grading of pNET.

关 键 词：胰腺肿瘤 神经内分泌肿瘤 病理学 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]