胰腺神经内分泌肿瘤超声表现

Ultrasonographic manifestations of pancreatic neuroendocrine tumors

目的观察胰腺神经内分泌肿瘤的常规超声表现及CEUS特征。方法回顾性分析我院经手术病理证实的90例胰腺神经内分泌肿瘤的常规超声表现及CEUS表现。结果 90例均接受常规超声、15例接受CEUS检查。90例中,单发肿瘤85例,多发5例;肿瘤位于胰头41例,胰体13例,胰尾36例。二维超声显示低回声81例,囊实混合回声8例,无回声1例,最大径0.80~12.50cm。67例肿瘤边界清楚,23例边界不清;64例肿瘤形态规则,26例形态不规则。CDFI示35例病灶血流信号丰富。主胰管增粗14例(14/90,15.56%)。15例接受CEUS,其中9例肿瘤动脉期呈高增强,延迟期呈稍高或等增强;4例动脉期呈稍高增强,延迟期呈低增强;2例动脉期周边呈稍低增强,延迟期廓清,内部可见片状不增强区。结论胰腺神经内分泌肿瘤常规超声多表现为边界清楚、形态规则的低回声团块,CEUS以动脉期均匀高增强、实质期无明显消退为主要特征。

Objective To observe manifestations of neuroendocrine tumors of pancreas （NETP） in conventional ultrasound and contrast enhanced ultrasonography （CEUS）. Methods Imaging features of histopathologically proved NETP in 90 patients were retrospectively analyzed. Results Conventional ultrasound was performed in all 90 patients, while CEUS was performed in 15 patients. Among all 90 cases, single lesion was found in 85 cases, while multiple lesions were found in 5 cases. The tumors located in pancreatic head （n= 41）, pancreatic body （n= 13） or tail （n= 36）, respectively. The lesions in 81 cases were hypoechoic, 8 were complex echoic and 1 was anechoic, with diameters ranged from 0.80 cm to 12.50 cm. Well-defined boundary of lesions were found in 67 cases, and ill-defined boundary of lesions were found in the other 23 cases. Regular shape lesions were found in 64 cases, while irregular shape lesions were found in 26 cases. Color Doppler ultrasound showed abundant tumor blood flow signals in 35 cases. Main pancreatic duct dilatation was found in 14 cases. Among 15 cases underwent CEUS, hyper-enhancement of tumors during the artery phase and slight hyper-enhancement or iso-enhancement during the delayed phase were observed in 9 cases, while slightly hyper- enhancement of tumors during artery phase and hypo-enhancement during delayed phase were observed in 4 cases. Slightly hypo-enhancement peripheral to the masses during artery phase and wash-out during delayed phase with plate-shaped regions without enhancement in the center of tumors were observed in 2 cases. Conclusion NETP mainly manifested as well-defined hypoechoic lesions with regular shape in pancreas in conventional ultrasound, hyper-enhancement during artery phase and no obvious wash-out during delayed phase in CEUS.