胰腺神经内分泌癌的影像诊断

Imaging diagnosis of pancreatic neuroendocrine carcinoma

目的探讨胰腺神经内分泌癌的CT和MRI表现,提高影像诊断水平。方法经手术病理证实的6例胰腺神经内分泌癌患者,均行CT平扫及增强扫描,其中3例行MR平扫及增强扫描。结果 6例中发生于胰头区和胰体尾部各3例,其中1例发现肝脏转移。CT表现为胰腺稍低密度占位,边界清楚,其内均可见囊变坏死,增强扫描动脉期病灶实质部分强化明显,胰腺期及平衡期肿瘤可持续强化或变成等密度。MRI平扫及动态增强信号表现与CT所见大体相似,但MRI在动脉期及胰腺期瘤体周围环形薄壁高信号强化为其特有特征。结论 CT和MRI结合检查,能显示胰腺神经内分泌癌的特征,在该病诊断及鉴别诊断中有重要价值。

Objective To investigate the CT and MRI findings of pancreatic neuroendocrine carcinoma and improve the diagnosis ability. Methods Imaging findings of six patients with pancreatic neuroendocrine carcinoma were retrospectively ana- lyzed. All patients underwent plain CT and contrast-enhanced CT examinations. Three of them underwent plain MRI and con- trast MRI. Results Three tumors were located in the pancreatic head and three in the pancreatic body. One patient had a meta- static lesion in liver. On plain CT, all tumors were well-defined and hypodensity with central areas of cystous putrescence. On contrast-enhanced CT, tumors manifested high enhancement in arterial phase and persistent enhancement in venous phase or bal- ance phase. （）n plain and contrast-enhanced MRI, it was a similar appearance with CT. But in arterial phase and persistent en- hancement, the ring-shaped hyperdensity enhancement of the tumors were diagnostic appearance. Conclusion CT and MRI scanning can demonstrate specific features of pancreatic neuroendocrine carcinoma, which is very important in diagnosis and dif- ferential diagnosis of the tumor.