MRI诊断膀胱神经内分泌肿瘤的价值  

The Value of MRI in the Diagnosis of Neuroendocrine Tumors of Bladder

作　　者：屠元冬 郝金钢[1] TU Yuandong;HAO Jingang(Department of Radiology,The Second Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province 650033,P.R.China)

机构地区：[1]昆明医科大学第二附属医院放射科,650033

出　　处：《临床放射学杂志》2025年第4期695-699,共5页Journal of Clinical Radiology

基　　金：云南省科技计划项目基础研究计划项目(编号:202401AY070001-373)。

摘　　要：目的探讨膀胱神经内分泌肿瘤的MRI影像学表现并与病理结果对照,以提高放射科及临床医师对该病的诊断水平。方法结合既往文献回顾性分析18例病理证实的膀胱神经内分泌肿瘤患者的MRI影像学资料,并与病理结果对照。结果小细胞神经内分泌癌(SCNC)7例,其中1例合并尿路上皮癌,病灶“菜花样”生长,与正常膀胱壁相比,T_(1)WI等信号,T_(2)WI稍高信号,增强扫描呈中度至明显强化,3例后期强化稍减退,扩散均明显受限;大细胞神经内分泌癌(LCNC)5例,其中1例合并尿路上皮癌,每一病例均存在膀胱肌层和周围脂肪组织侵犯,T_(1)WI等信号,T_(2)WI稍高信号,增强扫描呈明显进行性强化,扩散明显受限;副神经节瘤6例,形态较规则,T_(1)WI等/稍高信号,T_(2)WI稍高信号,可见“盐和胡椒征”,增强扫描呈明显强化,扩散明显受限,1例轻度受限。结论膀胱副神经节瘤MRI表现具有一定特点,可提高术前诊断准确率;膀胱SCNC及LCNC无特征性MRI表现,确诊仍依赖于病理检查。Objective To explore the MRI imaging findings of bladder neuroendocrine tumors and compare them with pathological findings in order to improve the diagnostic accuracy of radiologists and clinicians for the disease.Methods Based on the previous literature,the MRI imaging data of 18 patients with pathologically confirmed bladder neuroendocrine tumors were retrospectively analyzed and compared with the pathological results.Results 7 cases of small cell neuroendocrine carcinoma,of which 1 case was complicated by urothelial carcinoma.The tumor grew in a cauliflower pattern.T_(1)WI showed equal signal intensity,while T_(2)WI showed slightly higher signal intensity compared with normal bladder wall.The contrast enhancement was moderate to obvious enhancement,the delayed phase enhancement was slightly decreased in 3 cases,and the diffusion was obviously limited.5 cases of large cell neuroendocrine carcinoma,of which 1 case was complicated with urothelial carcinoma.Each case had invasion of bladder muscle layer and surrounding adipose tissue,T_(1)WI showed iso-signal,T_(2)WI showed slightly high signal,contrast enhancement showed obvious progressive enhancement,and diffusion was obviously limited.6 cases of paraganglioma.The shape of the tumor was regular,T_(1)WI showed equal/slightly high signal intensity,hyperintensity with“salt and pepper”appearance on T_2WI,contrast enhancement was obviously enhanced.Diffusion was obviously limited in 5 cases and mildly limited in 1 case.Conclusion The MRI findings of bladder paraganglioma have certain characteristics,which can improve the preoperative diagnosis,but the bladder SCNC and LCNC have no characteristic MRI findings,and the diagnosis still depends on pathological examination.

关 键 词：膀胱 神经内分泌肿瘤 磁共振成像 影像诊断 

分 类 号：R73[医药卫生—肿瘤]