胰腺神经内分泌肿瘤的CT表现与病理对照研究

Comparative Study on CT Findings and the Pathology of Pancreatic Neuroendocrine Tumors

探讨胰腺神经内分泌肿瘤(PNETs)不同病理分级间CT定性、定量指标的差异。回顾性分析88例经手术病理证实的PNETs患者CT影像资料,包括肿瘤位置、成分、边缘、胰管扩张、血管侵犯、脂肪浸润、直径、动脉和静脉绝对增强、动脉和静脉相对增强比、动脉和静脉增强比。肿瘤分级参照WHO分类2010年版消化系统肿瘤分级系统标准。88例PNETs均为单发,G1级21例、G2级52例、G3级15例;三组之间的年龄、性别和肿瘤位置比较差异无统计学意义(P>0.05),肿瘤成分、边缘、胰管扩张、血管侵犯、直径、动脉和静脉绝对增强、动脉和静脉相对增强比、动脉和静脉增强比的比较差异有统计学意义(P<0.05),多重比较中G1、G2肿瘤边缘、直径比较差异有统计学意义(P<0.05)。PNETs病灶呈现囊实性、病灶边缘不规则、胰管扩张、血管侵犯,以及较低的肿瘤动脉和静脉绝对增强、动脉和静脉相对增强比、动脉和静脉增强比与较高的术前病理分级有关。

To analyze CT qualitative and quantitative index of pancreatic neuroendocrine tumors(PNETs)in different pathological grades.In the retrospective study,88 histologically verified pancreatic neuroendocrine tumors were detected with enhanced CT.Various CT findings such as tumor location,component,margin,pancreatic duct dilatation,vascular invasion,fat infiltration,diameter,arterial and venous absolute enhancement,arterial and venous relative enhancement ratio,arterial and venous enhancement ratio were analyzed.Histopathological grade of PNETs was defined as:G1,G2,and G3 according to World Health Organization classification of tumors of the digestive system guidelines(2010).88 lesions were single lesions,with 21 lesions in G1,52 lesions in G2,and 15 lesions in G3.Significant differences were found among three groups in tumor component,margin,pancreatic duct dilatation,vascular invasion,diameter,arterial and venous absolute enhancement,arterial and venous relative enhancement ratio, arterial and venous enhancement ratio( P <0.05). There were significant differences in tumor margin, tumor diameter in multiple comparisons between G1 group and G2 group. The lesions with solid and cystic component, irregular edge, pancreatic duct dilatation, vascular invasion, and lower arterial and venous absolute enhancement, arterial and venous relative enhancement ratio, arterial and venous enhancement ratio are associated with higher pathological grade of PNETs.