肝脏原发性神经内分泌癌的影像学表现(附2例报告并文献复习)

CT and MRI findings of primary hepatic neuroendocrine carcinoma

目的:探讨肝脏原发性神经内分泌癌(PHNEC)的CT及MRI表现及鉴别诊断。方法:对2例经手术病理证实为PHNEC患者的影像学资料进行回顾性分析。结果:2例患者中,1例为肝右叶单发肿块,CT平扫表现为不均质低密度肿块伴囊变坏死,增强扫描表现为动脉期实性部分中度强化,门静脉期强化程度减低;MRI表现为T1WI低信号,T2WI高信号,伴内部坏死区长T1长T2信号。另1例患者表现为大肿块伴周围卫星灶,CT扫描呈低密度,增强扫描动脉期轻度强化,门静脉期强化程度减低。结论:PHNEC常表现为增强扫描动脉期轻至中度强化,门静脉期强化程度减低。肿块内囊变坏死及大肿块周围伴小结节可能为PHNEC较具特征性的表现。

Objective：To investigate the CT and MRI ifndings of primary hepatic neuroendocrine carcinoma （PHNEC） and its differential diagnosis. Methods： The data of CT and MR images of 2 cases with pathologically proved PHNECwere retrospectively analyzed. Results：One case with a single mass in the right hepatic lobe showed heterogeneous hypodense with intratumoral cystic degeneration on CT. The solid component was enhanced moderately in arterial phase and declined in portal venous phase. The mass with hypointensity on T1-weighed imaging （T1WI） and hyperintensity on T2-weighed imaging （T2WI） was shown on MRI. The other case had a dominant mass surrounded by satellite nodules and showed hypodense on non-enhanced CT. The masses were enhanced slightly in arterial phase and declined in portal venous phase. Conclusion：Slight to moderate enhancement in arterial phase and decline in portal venous phase was observed in PHNEC. Intratumoral cystic degeneration and dominant mass with satellite nodules might be the features.