原发性肝脏神经内分泌癌的MRI表现与病理对照研究

MRI findings of primary hepatic neuroendocrine carcinoma:correlation with pathology

目的:探讨原发性肝脏神经内分泌癌(PHNEC)的MRI表现及其病理基础,旨在提高其影像诊断水平。方法:回顾性分析8例经手术病理证实的PHNEC患者的MRI资料,分析其影像特点并与病理对照。结果:1例为单发结节型,病灶边界清晰,T1WI上呈低信号、T2WI上呈稍高信号,DWI上呈显著高信号,增强后动脉期有明显强化,门脉期及延迟期呈等信号;7例为巨块结节型,表现为巨大主灶伴周边卫星结节灶。主灶信号于T1WI上呈低信号、T2WI上呈稍高信号,DWI上呈显著高信号,增强后动脉期有明显强化,门脉期对比剂迅速廓清,延迟期周边可见环形强化的包膜影。卫星结节灶数目不等,大小不一,T1WI上呈低信号、T2WI上呈稍高信号,DWI上呈显著高信号,呈环形强化或均匀强化。结论:PHNEC的MRI表现具有一定特征性,常表现为不均质巨块结节型富血供病灶伴门脉期对比剂快速廓清及延迟期包膜强化。

Objective：To investigate the MRI findings of primary hepatic neuroendocrine carcinoma （PHNEC） and their correlation with pathologic features. Methods： MR images of 8 PHNEC patients confirmed by histopathology were ret- rospectively analyzed. The morphological characteristics and dynamic enhancement patterns were evaluated, and correlation of these imaging findings with histopathology was studied. Results：One case showed solitary nodule with homogenerous hy- pointensity on TI WI and hyperintersity on T2 WI and diffusion-weighted imaging （DWD. The remaining 7 cases appeared as well-defined dominant masses with variable satellite nodules. The dominant masses demonstrated heterogeneous hypointen- sity on TIWI and hyperintersity on T2 WI, which was associated with internal necrosis, cystic degeneration and fibrosis by histopathology. The dominant masses showed marked enhancement in arterial phase and rapid washout in portal venous phase after administration of contrast media. Six cases demonstrated capsular enhancement in equilibrium phase..The satel- lite nodules showed hypointensity on T1 WI and marked hyperintersity on T2 WI and DWI with homogeneous or rim-like en- hancement. Conelusion：PHNEC appears as multiple,well-defined, hypervascular lesions with rapid washout and capsular en- hancement on dynamic contrast enhancement images.