宫颈小细胞神经内分泌癌的影像学特征

Imaging features of small cell neuroendocrine carcinoma of the uterine cervix

目的:归纳分析总结宫颈小细胞神经内分泌癌(small cell neuroendocrine carcinoma of the uterine cervix,SCNECC)的影像学特征。方法:选取经术后病理学检查证实为SCNECC的患者22例、宫颈鳞癌患者30例、宫颈腺癌患者20例,对SCNECC、宫颈鳞癌和宫颈腺癌组的表观扩散系数(apparent diffusion coefficient,ADC)值及淋巴结转移率进行统计学分析,并复习国内外文献,归纳总结影像学特征。结果:SCNECC在磁共振成像(magnetic resonance imaging,MRI)上通常表现为T2高信号或稍高信号的肿块,扩散加权成像(diffusion-weighted imaging,DWI)上呈高信号,ADC值显著低于其他类型宫颈癌,差异有统计学意义。SCNECC组比宫颈鳞癌组和宫颈腺癌组转移率高,差异有统计学意义。结论:综合CT、超声及MRI检查可以帮助临床诊断SCNECC,ADC值有助于辅助诊断SCNECC,在宫颈癌筛查中也有一定价值。

Objective:To analyze and summarize the imaging features of small cell neuroendocrine carcinoma of the uterine cervix (SCNECC).Methods:A total of 22 patients with pathologically confirmed SCNECC,30 patients with cervical squamous cell carcinoma and 20 patients with cervical adenocarcinoma were enrolled in this study.The apparent diffusion coefficient (ADC) values of SCNECC,cervical squamous cell carcinoma and cervical adenocarcinoma and lymph node metastasis rate were analyzed and the imaging characteristics of SCNECC were summarized.Results:SCNECC on magnetic resonance imaging (MRI)was usually shown as high signal or slightly high signal T2 tumor,on diffusion-weighted imaging (DWI)was shown high signal with low ADC value,which was significantly lower than other types of cervical cancer.The lymph node metastasis rate in SCNECC group was significantly higher than those in cervical squamous cell carcinoma group and cervical adenocarcinoma group.CT often showed irregular cervical enlargement and continuous heterogeneous enhancement.Ultrasound often showed a small amount of blood flow within the heterogeneously hypoechoic mass.Conclusion:Combination of CT,ultrasound and MRI examinations can help to accurately diagnose SCNECC.ADC value has certain predictive role in the diagnosis of SCNECC.