原发性肝脏神经内分泌癌的CT特征

CT Features of Primary Hepatic Neuroendocrine Carcinoma

目的探讨原发性肝脏神经内分泌癌(PHNEC)的CT特征。方法回顾性分析6例经手术病理证实的PHNEC的CT检查资料,均行平扫及增强检查。结果 16例患者中单发3例,2例位于肝右叶,1例位于肝左叶;3例多发,表现为单个较大肿块伴多发子灶。肿瘤最大径1.8-8.5cm。2CT表现:均无肝硬化背景,CT平扫均为实性低密度肿块或结节,边界清晰。动态增强扫描5例动脉期不均匀明显强化,其中3例门脉期持续强化呈不均匀稍高密度,2例门脉期开始廓清呈低密度。1例单发病灶动脉期轻度强化,门静脉期持续强化,延迟期呈相对低密度。结论 PHNEC的CT表现具有一定的特征性,常表现为肝内单发低密度肿块或一较大肿块伴多发子灶,增强后肿瘤大多动脉期明显强化,门脉期持续强化,少数表现为轻中度持续强化,CT检查有助于术前诊断。

Objective To investigate the CT features of primary hepatic neuroendocrine carcinoma （PHNEC）.Methods CT finding of 6 cases with PHNEC proved by pathology were analyzed retrospectively, all were performed plain and dynamic enhanced CT scanning.Results ① Of the 6 cases, 3 cases showed single lesion, and 2 cases in the right lobe, 1 case in the left lobe. 3 cases of multiple, showed single large tumor with multiple nodules .Tumor diameters were 1.8-8.5 cm. ② CT findings： All had no cirrhosis background, CT scan showed solid density lumps or nodules with clear boundary. Dynamic enhanced scan： 5 cases inhomogeneous significantly enhanced at arterial phase, and 3 cases continued to strengthen with uneven slightly density, 2 cases dissected with low density at portal venous phase. 1 case of solitary lesions slight enhanced at arterial phase, continued to strengthen at portal venous phase, showed relatively low density at delay period.Conclusion The CT findings of PHNEC had certain characteristics, usually showed hepatic single low-density mass or a large mass with multiple Nodules, Most tumors significantly enhanced at arterial phase, continued to strengthen at portal phase, a few showed mild to moderate persistent enhancement, CT exam was useful for the diagnosis before surgery.