胰腺神经内分泌肿瘤的影像表现及病理分级

Neuroendocrine tumors of the pancreas: imaging features and pathological grade

目的：探讨胰腺神经内分泌肿瘤的影像学表现与病理分级的相关性。方法回顾性分析16例经手术病理证实的胰腺神经内分泌肿瘤的CT、MRI表现，包括瘤体大小、内部成分（囊实性）、强化方式等，根据2010年WHO胰腺神经内分泌肿瘤的病理分级，运用Pearson相关性分析、Spearman等级相关性分析不同级别肿瘤的影像征象是否具有统计学差异。结果16例患者16个病灶，横径最大径约20～70mm，肿瘤以实性成分为主的7例，以囊性为主的4例，病灶呈囊实混合性的5例。动态增强示病灶动脉期明显强化的8例；病灶呈渐进性强化的8例。 G1级肿瘤9个，G2级肿瘤5个，G3级肿瘤2个，肿瘤级别与肿瘤大小、内部成分、强化方式无明显相关性。结论较大的肿瘤易囊变，肿瘤病理分级往往较高。

Objective The objective of our study was to evaluate the imaging features of incidentally detected neuroendocrine tumors （NETs） of the pancreas, to identify the correlation between imaging features and tumor grade on histopathyology .Meth-ods In the retrospective study , 16 histologically verified pancreatic NETs incidentally detected with contrast -enhanced MDCT and magnetic resonance imaging MRI were included .Various imaging features such as size , pattern, enhancement were analyzed .All the tumors were graded as G 1 to G3 according to the WHO classification in 2010 .Pathological grades of NETs of the pancreatic were correlated with findings on imaging by Pearson＇s correlation analysis .Spearman＇s rank correlation analysis was used to ana-lyzed the difference.Results A total of pancreatic NETs were 16 （mean diameter 42 mm, rang, 20~70 mm）.A solid pattern was observed in 5 tumors and cystic changes were present in 11 tumors.Of these 11 tumors, 4 were predominantly cystic , whereas 7 lesions were noted to be solid and cystic .Intense enhancement of tumors on MDCT , MRI was observed in 8 of 16 patients on contrast-enhancement imagings ether intense early enhancement or enhancement progressively .Ehancement was minimal on these imagings in the other 8 patients.9 cases of the tumors were graded as G1, 5 cases as G2, 2 cases as G3.Among these features, there was no strongly statistic difference between features on imagings and clinical -pathologic grade in NETs of the pancreatic . Conclusion Most NETs of pancreas were large with a cystic patter ,and higher grade on pathology were presented .