胆囊神经内分泌肿瘤的CT与MRI影像学表现

CT and MRI Imaging Findings of Gallbladder Neuroendocrine Tumor

【目的】总结胆囊神经内分泌肿瘤的CT与MRI影像学表现特征。【方法】回顾性分析2010年1月至2018年5月经手术病理证实的10例胆囊神经内分泌肿瘤的CT与MRI检查资料,其中6例仅行胆囊CT检查,3例仅行MRI检查,1例同时行CT与MRI检查。观察胆囊肿瘤的大小、形态、强化方式,是否合并肝转移、胆管与肝周转移、淋巴结转移、胆囊结石等情况。【结果】10例胆囊神经内分泌肿瘤,肿块T1最大径为39~120mm,表现为广基底附着于胆囊壁,并突向胆囊腔内;其中7例CT表现为软组织密度不规则肿块;4例MRI上,肿瘤在T1加权成像为均匀等信号,T2加权成像为不均匀高信号,弥散加权成像上弥散受限。10例胆囊肿瘤增强后呈中度不均匀持续性强化。10例中,8例伴有肝转移,其中肝4、5段转移7例,其它肝段多发转移1例;6例侵犯胆管,3例侵犯肝门部脂肪;7例伴有肝门或腹膜后淋巴结转移;1例合并胆囊结石。【结论】胆囊神经内分泌肿瘤CT及MRI表现有一定特征性,多表现为胆囊部位的大肿块,易侵犯邻近的肝实质,沿胆囊颈、胆囊管蔓延,伴肝门、腹膜后淋巴结转移,并肝门部脂肪侵犯。

【Objective】To summarize the CT and MRI imaging features of gallbladder neuroendocrine tumor.【Methods】CT and MRI data of 10 patients with gallbladder neuroendocrine tumors proven by surgical pathology between January 2010 and May 2018 were retrospectively analyzed.Among them,6 patients underwent CT examination, 3 underwent MRI examination,and 1 patient underwent both CT and MRI examinations.The size,morphologic features and contrast enhancement pattern of gallbladder tumors,and the presence of liver metastasis,bile duct and perihepatic metastasis,lymph node metastasis,and the presence of gallbladder stone were assessed.【Results】Among these 10 cases of gallbladder neuroendocrine tumor,the largest dimension of tumors ranged from 39 mm to 120 mm.The tumors manifested as a mass protruding into the lumen with a broad base adhering to the wall of the gallbladder.In 7 patients who had undergone CT examination,the tumors manifested as an irregular mass with soft tissue density on CT.In 4 patients who had undergone MRI,the tumors showed homogeneous iso-intense signal on T1-weightedimaging,heterogenous hyper-intense signal on T2-weighted imaging,and limited diffusion on diffusion-weighted imaging.All tumors in 10 patients showed moderate,heterogeneous and persistent enhancement.Eight patients had liver metastasis,among whom 7 had metastases in liver segments 4 and 5,and 1 had multiple metastases in other liver segments.Six patients had bile duct invasion and 3 had hilar fat invasion.Seven patients had lymph node metastasis.One patient had gallstone.【Conclusion】Gallbladder neuroendocrine tumor has certain characteristic CT and MRI findings,such as a large mass in gallbladder,which tends to invade adjacent liver parenchyma,and extend along gallbladder neck and gallbladder ducts,accompanied with hepatic portal and retroperitoneal lymph node metastasis,and hilar fat invasion.