MSCT在胰腺神经内分泌肿瘤诊断及其鉴别诊断的应用价值

Diagnosis and differentiation of pancreatic neuroendocrine tumors with multi-slice spiral CT

目的 探讨胰腺神经内分泌肿瘤的MSCT表现,以提高对其诊断水平。方法 回顾性分析15例经手术后病理证实为NETP患者的MSCT表现。将神经内分泌瘤与神经内分泌癌分组对各期CT值进行统计学分析。结果 15例中,男性4例,女性11例,年龄22~68岁,平均46岁。9例胰腺神经内分泌瘤,5例胰腺神经内分泌癌,1例混合性腺泡-神经内分泌癌。胰头5例、胰颈5例、胰体尾部5例。13例表现为实性肿块,2例表现为囊实性肿块。4例肿瘤的强化较均匀,11例为不均匀强化,其中3例表现为边缘环形强化。神经内分泌瘤与神经内分泌癌的各期CT值无统计学差异。结论 神经内分泌肿瘤的影像学表现多样,认识其多样性及不典型影像学征象,对提高诊断水平有较大帮助。

Objective To improve the diagnostic accuracy of pancreatic neuroendocrine tumors by means of multiple slice CT（MSCT）. Methods We retrospectively analyzed MSCT performance of 15 patients who were NETP confirmed by postoperative pathology. The CT value of pancreatic neuroendocrine tumour was compared with pancreatic neuroendocrine carcinoma. Results Among 15 patients, verage age was 46 years old, ranged from 22 to 68 years. 4 patients were male and 11 patients were female. 9 cases were pancreatic neuroendocrine tumor, 5 cases were pancreatic neuroendocrine carci- noma, 1 case were mixed acinar endocrine carcinoma. 5 cases located in pancreatic head, 5 cases located in pancreatic neck, 5 cases located in body and tail of pancreas. 13 cases showed solid mass and 2 cases showed cystic mass. 4 cases showed uniform enhancement and 11 cases showed heterogeneous enhancement in which 3 cases showed ring enhancement. 11 cases showed medium degree enhancement in arteriovenous phase, 4 cases showed slight enhancement in arterial phase, increased slightly in venous phase which were significantly lower than the pancreatic parenchyma. There was no difference in the CT value between pancreatic neuroendocrine tumour and pancreatic neuroendocrine carcinoma. Conclusion The typ- ical performance of neuroendocrine tumors are obvious enhancement and coated enhancement, but those imaging perform- ance are diversified. It can improve the diagnostic accuracy rate by understanding of the diversity and atypical radiological signs.