原发性纵隔神经内分泌癌CT表现特征  

CT features of primary mediastinal neuroendocrine carcinoma

作　　者：李勐 余捷 许崇永[3] 邱乾德 Li Meng;Yu Jie;Xu Chongyong;QiuQiande(Department of Radiology,Yueqing People's Hospital of Zhejiang,Yueqing 325600,China;Department of Radiology,Wenzhou People's Hospital of Zhejiang Province,Wenzhou 325000,China;Department of Radiology,the A ffiliated Second Hospital of Wenzhou Medical University of Zhejiang Province,Wenzhou 325000,China)

机构地区：[1]浙江省乐清市人民医院放射科,325600 [2]浙江省温州市人民医院影像科,325000 [3]浙江省温州医科大学附属二院放射科,325000

出　　处：《中华内分泌外科杂志》2019年第6期483-487,共5页Chinese Journal of Endocrine Surgery

摘　　要：目的探讨原发性纵隔神经内分泌癌的CT特征,提高诊断准确性。方法回顾性分析经临床、病理确诊的12例原发性纵隔神经内分泌癌患者CT表现,观察肿瘤的部位、大小、生长方式、密度、强化程度、侵犯周围组织及转移等特点,并与病理结果进行对照分析。结果12例中肿瘤位于前上纵隔4例,中上纵隔4例,中纵隔4例;其中偏左侧5例,偏右侧4例,位于正中3例。肿瘤最大径1.5-12.0 cm,平均(6.74±3.65)cm。肿瘤呈圆形或类圆形6例,形态不规则6例,肿瘤边界清楚9例,边界不清3例。密度均匀6例;密度不均匀6例,其中坏死、囊变4例,瘤内见细点状钙化1例;平扫CT值平均(38±4.8)HUO包绕血管生长1例,邻近血管受压2例,侵犯邻近胸膜3例,浸润周围脂肪间隙6例。增强后均呈轻、中度强化,其中均匀强化4例,不均匀强化8例。增强后CT值平均(55±7.7)HU;其中轻度强化9例,中度强化3例。瘤内可见小线状异常强化血管影3例,中心坏死、囊变区未见强化4例。典型类癌7例,不典型类癌2例,小细胞癌2例,大细胞神经内分泌癌1例。结论原发性纵隔神经内分泌癌多位于前中纵隔,瘤体较大时易出现坏死、囊变和侵袭性生长,增强扫描呈轻、中度强化,结合临床病史,能提高诊断的准确性。Objective To investigate the CT features of primary mediastinal neuroendocrine carcinoma and improve the diagnostic accuracy.Methods CT findings of 12 patients with primary mediastinal neuroendocrine carcinoma diagnosed by clinic and pathology were retrospectively analyzed.The location,size,growth pattern,density,degree of enhancement,invasion of surrounding tissues and metastasis of the tumor were observed,a control analysis was performed.Results Among the 12 cases,4 cases were located in the anterior superior mediastinum,4 cases in the middle superior mediastinum and 4 cases in the middle mediastinum.There were 5 cases on the left side,4 cases on the right side and 3 cases in the middle.The maximum diameter of the tumor ranged from 1.5 cm to 12.0 cm,with an average of(6.74±3.65)cm.The tumors were round or quasi-round in 6 cases,irregular in 6 cases,clear boundary in 9 cases and unclear in 3 cases.Uniform density was found in 6 cases.The density was heterogeneous in 6 cases,including necrosis and cystic degeneration in 4 cases,and fine-grained calcification in 1 case.The average CT value of plain scan was(38±4.8)HU.There was 1 case of perivascular growth,2 cases of adjacent vascular compression,3 cases of adjacent pleural invasion,and 6 cases of infiltrating the surrounding fat space.After contrast enhancement,all cases showed mild and moderate enhancement,including 4 cases with homogeneous enhancement and 8 cases with heterogeneous enhancement.After contrast enhancement,the mean CT value was(55±7.7)HU.There were 9 cases with mild enhancement and 3 cases with moderate enhancement.There were 3 cases with small linear abnormally enhanced vascular shadow in the tumor,and 4 cases with no enhancement both in the central necrosis and the cystic areas.There were 7 cases of typical carcinoid,2 cases of atypical carcinoid,2 cases of small cell carcinoma and 1 case of large cell neuroendocrine carcinoma.Conclsion Primary mediastinal neuroendocrine carcinoma is mainly located in the anterior-mediastinum.When the tumor i

关 键 词：纵隔肿瘤 神经内分泌癌 体层摄影术 X线计算机 

分 类 号：R734.5[医药卫生—肿瘤] R730.44[医药卫生—临床医学]