消化系统神经内分泌肿瘤病理学特征与CT表现的关系  

Relationship between CT findings and pathological features of neuroendocrine tumor in digestive system

作　　者：李文勤[1] 杨传彬[2] 于德新[3] 李晶磊[1] 林椿森 LI Wenqin;YANG Chuanbin;YU Dexin;LI Jinglei;LIN Chunsen(Department of Radiology,Shandong Tai＇an Rongjun Hospital,Tai＇an 271000,China;Department of Radiology,Shandong Chest Hospital,Ji＇nan 250010,China;Department of Radiology,Qilu Hospital of Shandong University,Ji＇nan 250012,China)

机构地区：[1]山东省泰安荣军医院影像科,山东泰安271000 [2]山东省胸科医院放射科,山东济南250010 [3]山东大学齐鲁医院放射科,山东济南250012

出　　处：《实用放射学杂志》2018年第8期1213-1216,共4页Journal of Practical Radiology

摘　　要：目的探讨消化系统神经内分泌肿瘤（NENDs）CT表现特征与病理分级之间的关系。方法收集经病理证实的NENDS患者共56例，对其临床及影像学资料进行回顾性分析。根据手术或内窥镜活检的病理结果将肿瘤分为G1～G3期。肿瘤的CT表现包括：病灶的发生部位、最大径、形态、钙化、密度、边缘情况、强化程度、强化均匀度、强化曲线类型，同时记录邻近结构及血管有无受累、有无腹水，以及腹膜、淋巴结及其他脏器的转移等。分析上述CT表现在病理分级之间的差异。结果NENDS的G1～G3期之间，病灶的最大径、形态、钙化、边缘、对邻近组织及血管的浸润，以及淋巴结、腹膜和远处脏器的转移，动脉期强化程度及动脉期、静脉期和延迟期的强化均匀度等均有统计学差异（P〈0．05）。而平扫时NENDS的密度、腹水、静脉期和延迟期强化程度、曲线类型等均无统计学差异（P〉0.05）。结论病灶的大小、形态、钙化、边缘、浸润和转移、动脉期强化程度及3期强化均匀度等与NENDS病理分级关系密切，有助于G1～G3分级的鉴别。Objective To investigate the relationship between CT features and pathological grades of neuroendocrine neoplasm in digestive system （NENDS）. Methods A total of 56 patients with NENDS confirmed by pathology were collected in the study.The clinical and imaging data of the patients were analyzed retrospectively.The tumors were classified into 3 grades （G1- G3）according to the pathological results of surgery or endoscopic biopsy.The CT manifestations of NENDS included the location, maximum diameter, shape, calcification, density, the margin, the degree and uniformity of enhancement, the types of enhanced time-density curve, and the invasion into adjacent structures or blood vessels,ascites,and the metastasis of peritoneum,lymph nodes or other organs.The difference in the above imaging findings among three pathological grades was analyzed.Results There were statistically significant differences between any two groups among the three pathological grades （G1-G3 ） in maximum diameter, shape, calcification, margin, invasion into adjacent tissues and blood vessels, the metastasis of lymph nodes, peritoneum and distant organs, degree of enhancement in arterial phase, and uniformity of enhancement in arterial, venous and delayed phases （P〈0.05）. However,there was no significant difference in density on plain CT, ascites,degree of enhancement in venous and delayed phases, and the types of enhanced time-density curve among three pathological grades （ P〉0.05 }. Conclusion The multiple-phase CT imaging features of NENDS, including size, shape, calcification, margin, invasion, metastasis, degree of enhancement in arterial phase and uniformity of enhancement in three phases are closely related to the pathological grades,and thus CT is helpful to differentiate the histological grade of NENDS.

关 键 词：神经内分泌肿瘤 消化系统 病理分级 计算机体层成像 

分 类 号：R735.9[医药卫生—肿瘤] R446.8[医药卫生—临床医学]