胰腺多发神经内分泌肿瘤12例影像学表现

Imaging findings of pancreatic multiple neuroendocrine tumor：A study of 12 cases

目的：探讨多个病灶的胰腺神经内分泌肿瘤（PNETs）CT及MR影像学特征，以加深对该病的认识。方法回顾性分析上海长海医院收治的胰腺肿瘤数目≥2枚且经手术或细针穿刺活检病理证实为PNETs的12例患者的影像学资料，其中5例行胰腺CT平扫及增强检查，2例行MRI平扫及增强检查，5例同时行CT、MRI检查。结果12例患者共检出46枚病灶，29枚（63．0％）位于胰头颈，17枚（37．0％）位于胰体尾；病灶大小0．8～9．5 cm，中位大小2．9 cm；44枚（95．7％）肿瘤形态圆形或类圆形，2枚（4．3％）为分叶状；实性44枚（95．7％），囊实性2枚（4．3％）。8枚（17．4％）CT平扫可见点状、新月形、团块状钙化；增强后42枚（91．4％）病灶动脉期明显强化，2枚（4．3％）胰腺期明显强化，2枚（4．3％）3期均呈轻度强化，强化程度低于正常胰腺。4例（33．3％）患者出现胰管和（或）胆管扩张，4例（33．3％）出现脏器转移，2例（16．7％）有淋巴结转移，3例（25．0％）有血管侵犯。结论 PNETs可以多发，为大小不一、圆形或类圆形实性病灶，偶见脏器转移等恶性征象，动态增强扫描病灶实性部分明显强化且强化程度高于正常胰腺是其特征性表现。

Objective To investigate the imaging features in CT/MR of pancreatic neuroendocrine tumors（PNETs） with multiple lesions and further deepen the understanding of this disease .Methods A retrospective review of 12 PNETs patients′radiological data with pancreatic tumors′numbers≥2 and confirmed by surgery or fine needle aspiration biopsy in Changhai Hospital were conducted .Five cases underwent pancreatic CT plain and enhanced scan , 2 cases underwent MRI plain and enhanced scan , and 5 cases underwent both CT and MRI scan .Results There were totally 46 lesions in 12 patients.There were 29 （63.0%） lesions located in the pancreatic head and neck , and 17（37.0%） lesions located in body and tail of pancreas.The sizes of the lesions ranged from 0.8 to 9.5 cm,and the median size was 2.9 cm.Forty-four （95.7%） of the tumors was round or oval , and 2 （ 4.3%） was lobulated;44 （ 95.7%） mass solid and 2 （4.3%） was cystic.CT plain scan detected punctate , crescent or nodular calcification in 8（17.4%） lesions;enhanced scan found 42 lesions（91.4%） were markedly enhanced in the arterial phase , 2 lesions （4.3%） were markedly enhanced in the pancreatic phase;2 lesions （4.3%） were slightly enhanced and the degree of enhancement was lower than that of the normal pancreas .Four cases （33.3%） had dilatation of pancreatic duct and/or the bile duct, 4 cases （33.3%） had distant organ metastasis, 2 cases （16.7%） had lymph node metastasis, and 3 cases （25.0%） had vascular invasion .Conclusions PNETs can be multiple and vary in the size.Most of the lesions are round or oval solid lesions and the malignant signs for organ metastasis can be＆amp;nbsp;found occasionally .In dynamic enhanced scanning , the obvious enhancement of the solid portion in the tumor and the higher enhancement degree than that of normal pancreas is the main characteristic .