3.0T磁共振在胃肠道神经内分泌肿瘤诊断中的价值

Value of 3. 0 T MRI in the Diagnosis of Gastrointestinal Neuroendocrine Tumor

目的探讨3.0 T磁共振在胃肠道神经内分泌肿瘤诊断中的价值。方法回顾性分析6例经手术后病理证实的胃肠道神经内分泌肿瘤患者的MRI表现,并与病理结果对照。结果 6例患者中病灶均显示管壁增厚,管腔不同程度狭窄,最大病灶大小约6.1 cm×2.6 cm×2.4 cm。MRI主要表现T1WI等信号3例,稍低信号3例;T2WI脂肪抑制表现为等信号2例,稍高信号4例;DWI序列中,6例病灶均为高信号。动态增强扫描,4例病灶动脉期明显强化,其中3例静脉期及延迟期强化减弱,另1例静脉期及延迟期持续强化;2例病灶始终呈轻中度强化。2例发生于胃部病灶及1例发生于直肠的病灶向壁外浸润。结论胃肠道神经内分泌肿瘤多表现为T1WI上等或稍低信号,T2WI上等或稍高信号,DWI扩散受限,动态增强扫描呈"快进快出"表现。MRI对其诊断和鉴别诊断有重要价值。

Objective To investigate the value of 3.0 T MRI in the diagnosis of gastrointestinal neuroendocrine tumor. Methods 3.0T MR imaging findings of 6 patients with gastrointestinal neuroendocrinc tumor confitmed by pathology were retrospectively analyzed, and compared with the pathological results. Results Lesions in 6 patients showed wall thickening and luminal stenosis. The size of the largest lesion was about 6.1 cm× 2.6 cm ×2.4 cm. The signal intensity was isointensity in 3 patients, slightly low signal intensity in 3 patients on T1WI; isointensity in 2 patients, slightly high signal intensity in 4 patients on T2WI fat suppression sequence. All lesions of 6 cases showed high signal intensity on DWI sequence. After dynamic contrast-enhanced scan, 4 cases had obvious enhancement in the arterial phase, of which 3 cases were mild and 1 case had persistent enhancement in the venous phase and delayed phase. 2 cases of lesions always showed mild-to-moderate enhancement. 2 cases occurred in gastric lesions and 1 case occurred in a rectal lesion that extended beyond the wall. Conclusion Most gastrointestinal neuroendocrine tumors show isointensity or slightly low signal on T1WI, isointensity or slightly high signal on T2WI, diffusion restriction on DWI, ＂fast in fast out＂ after dynamic contrast-enhanced scan. MRI plays an important role in the diagnosis and differential diagnosis of gastrointestinal neuroendocrine tumor.