纵隔神经内分泌肿瘤CT的诊断价值

Diagnostic Value of CT in Mediastinal Neuroendocrine Tumors

目的探讨CT对于纵隔神经内分泌肿瘤的诊断价值。方法回顾并分析21例我院病理确诊为纵隔神经内分泌肿瘤患者的临床及影像资料。CT图像分析包括病变大小、位置、密度、形态、坏死、钙化、强化方式、周围组织侵犯程度、淋巴结及远处转移。结果21例患者,位于前纵隔11例,前中纵隔2例,中纵隔8例;17例不规则或分叶状,4例类圆形;20例见坏死,5例伴点状钙化灶;18例周围脂肪间隙模糊或消失,3例清晰;4例轻度强化,15例中度强化,2例重度强化;侵犯胸壁及胸膜各1例,侵犯心包5例,侵犯纵隔大血管13例;9例纵隔淋巴结转移,2例肺门淋巴结转移,锁骨上窝及肝胃间隙淋巴结转移各1例。结论MNEC的CT征象有一定特点,认识这些征象对于提高纵隔神经内分泌肿瘤诊断的准确性有一定价值。

Objective To explore the diagnostic value of CT for mediastinal neuroendocrine tumors.Methods To review and analyze the clinical and imaging data of 21 patients with pathologically confirmed mediastinal neuroendocrine tumors in our hospital,all the patients underwent CT plain scan and enhancement scan.CT image analysis included lesion location,size,morphology,density,necrosis,calcification,enhancement pattern,surrounding tissue invasion,lymph nodes and distant metastasis.Results Of the 21 patients,11 were located in the anterior mediastinum,2 in the anterior middle mediastinum,and 8 in the middle mediastinum;17 were irregular or lobulated,and 4 were similarly rounded;necrosis was seen in 20 cases,and 5 were accompanied by punctate calcification foci;the surrounding fatty space was blurred or disappeared in 18 cases,and 3 were clear;4 were mildly enhanced,15 were moderately enhanced,and 2 were severely enhanced;one invaded the chest wall and pleura,5 invaded the pericardium,and 13 invaded the large mediastinal vessels;9 had mediastinal lymph node metastasis,2 had hilar lymph node metastasis,and 1 had lymph node metastasis in the supraclavicular fossa and hepatogastric space.Conclusion The CT signs of mediastinal neuroendocrine tumors have certain characteristics,and recognizing these signs is valuable for improving the accuracy of the diagnosis of mediastinal diseases.