胆囊神经内分泌肿瘤的CT与MRI影像学特征及其诊断价值

CT and MRI findings of gallbladderneuroendocrine carcinomas and their diagnostic value

目的分析胆囊神经内分泌肿瘤(NECs)的CT与MRI影像学表现特征及其诊断价值。方法回顾性分析2015年6月至2020年6月南阳医学高等专科学校第一附属医院收治的并经病理学证实的30例NECs患者的临床资料,20例行CT检查,7例行MRI检查,3例同时行CT和MRI检查,观察肿瘤大小、形态,是否合并转移及胆囊结石等情况,并比较CT与MRI检出率。结果 30例NECs患者中,CT表现为软组织密度不规则肿块,增强后中度不均匀持续性强化;MRI表现为T1WI均匀等信号,T2WI不均匀稍高信号,DWI弥散受限,增强后中度不均匀持续性强化;30例NECs中20例出现肝转移,18例胆管受侵,9例侵犯肝门部脂肪,19例伴淋巴结转移,2例合并胆囊结石。CT诊断NECs的准确性为95.65%,MRI诊断NECs的准确性为90.00%,两者比较差异未见统计学意义(P>0.05)。结论 CT与MRI诊断NECs的价值均高,且两者表现有一定特征性,多表现为胆囊部位肿块,且易侵犯肝实质,并伴淋巴结转移和肝门部脂肪侵犯。

Objective To analyze CT and MRI findings of gallbladder neuroendocrine carcinomas(NECs)and their diagnostic value.Methods Clinical data of 30 patients with pathologically confirmed NECs who were treated at the First Affiliated Hospital of Nanyang Medical College during June 2015 and June 2020 were retrospectively analyzed.Twenty cases underwent CT examination,7 cases underwent MRI examination,and 3 cases underwent both CT and MRI examinations to observe size,shape and enhancement method of the tumor,liver metastasis,lymph node metastasisand gallbladder stones.The detection rates ofCT and MRI were compared.Results CT showed irregular soft tissue density lumps,with moderate,uneven and continuous enhancement after enhancement scan.MRI showed uniform equal signals on T1WI,uneven slightly high signal on T2WI,limited DWI diffusion,and moderate,uneven and continuous enhancement after enhancement scan.Of the 30 patients with NECs,20 had liver metastases,18 had bile duct invasion,9 had hilar fat invasion,19 had lymph node metastasis,and 2 had gallbladder stones.The accuracy of CT in the diagnosis of NECS was 95.65%,and that of MRI was 90.00%,there was no significant difference between them(P>0.05).Conclusions Both CT and MRI can be used to diagnose NECs,and manifestations mainly include gallbladder masses andliver parenchyma invasion,with lymph node metastasis and hilar fat invasion.