十二指肠神经内分泌肿瘤的CT表现(4例报道合并文献复习)

CT Features of Neuroendocrine Tumors of the Duodenum( Report of 4 Cases and Literature Review)

目的探讨十二指肠神经内分泌肿瘤的CT特点。方法分析4例经病理证实的十二指肠神经内分泌肿瘤的CT表现,并结合文献探讨其临床病理及CT特点。结果 4例中,十二指肠球部1例、降部2例、水平部1例;1例病灶向腔内生长呈息肉状,2例表现为肠壁内肿块,1例病灶呈腔外生长。肿瘤最大径1.6～4.9 cm,平均3.4 cm。4例病灶平扫为等密度或稍低密度,密度均匀者3例,不均匀者1例。增强扫描动脉期病灶强化明显者2例,中度强化2例;均匀强化3例,不均匀强化1例。整个动态增强中肿瘤以动脉期强化明显,门静脉期和平衡期强化程度逐渐降低。结论当十二指肠近段出现息肉样或壁内肿块,CT动态增强病灶早期强化明显,门静脉期及延迟期强化程度逐渐减低时应考虑到神经内分泌肿瘤的可能。

Objective To investigate the CT findings of duodenal neuroendocrine tumors. Methods CT findings of four patients with duodenal neuroendocrine tumors proved by pathology were retrospectively analyzed. The literature, clini cal pathologic characteristic and CT features were investigated. Results Among four cases,the lesions located in the bulb （ 1/4）, the second portion （2/4） and in the third portion （1/4）. One patient had a focal intraluminal polypoid mass and two had mural masses, and one presented with extrinsic mass. The tumor size ranged from 1.6 to 4.9 em （ mean = 3.4 era）. On unenhaneed CT image, four lesions showed isodensity or slightly low density, homogenous in three cases and her erogenous in one case. On contrast enhanced CT image, two cases showed obvious enhancement and the others showed mild enhancement at arterial phase, with homogenous enhancement in three cases and heterogenous enhancement in one case. During the dynamic contrast enhanced CT, the mass showed obvious enhancement at arterial phase and loss of enhancement at portal venous phases and delayed imaging. Conclusion The possibility of neuroendoerine tumors should be considered when an intraluminal polypoid or mural mass located in the proximal duodenum, especially with obvious enhancement at ar terial phase and loss of enhancement at portal venous and delayed imaging during three phase of intravenous contrast en hanced CT.