天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (2): 178-182.doi: 10.11958/20171140

• 临床研究 • 上一篇    下一篇

高、 低级别胰腺神经内分泌肿瘤的CT及MRI表现

徐香红， 张雪， 陈文林， 胡春峰△   

  1. 徐州医科大学附属医院影像科 （邮编221000）
  • 收稿日期:2017-10-23 修回日期:2017-12-03 出版日期:2018-02-15 发布日期:2018-02-15
  • 通讯作者: 徐香红 E-mail:1270381998@qq.com

High- and low-grade pancreatic neuroendocrine tumors: CT and MRI features

XU Xiang-hong, ZHANG Xue, CHEN Wen-lin, HU Chun-feng△   

  • Received:2017-10-23 Revised:2017-12-03 Published:2018-02-15 Online:2018-02-15
  • Contact: Xiang-Hong XU E-mail:1270381998@qq.com

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摘要： 摘要:目的 分析高、 低级别胰腺神经内分泌肿瘤 （PNET） 的 CT 及 MRI 表现。方法 回顾性分析 2011 年 1 月—2017 年 5 月 32 例 PNET 患者的临床、 影像及病理资料， 其中低级别 （G1、 G2） 21 例， 高级别 （G3） 11 例。患者术前行 CT 或 MRI 平扫及增强检查， 术后行病理分析予以确诊。比较高、 低级别 PNET 间影像学表现差异。结果 32 例患者中， 单发 31 例， 多发 1 例。G1 级 12 例， G2 级 9 例， G3 级 11 例。病灶位置： 胰头 10 例 （G3 级 8 例）， 胰体 10 例， 胰尾 12 例。形态： 类圆形 19 例， 不规则形 13 例。内部成分： 实性 16 例， 囊实性 14 例， 囊性 2 例。钙化 5 例。胰、 胆管扩张 3 例 （均为 G3 级）。其他脏器或淋巴结转移 4 例 （均为 G3 级）， 其中肝转移 2 例， 淋巴结转移 2 例。高级别 PNET 通常位于胰头， 肿瘤体积较大， 形态常不规则， CT 或 MRI 增强后一般表现为低强化， 可伴有胰胆管扩张及其他脏器或淋巴结转移。结论 高、 低级别胰腺神经内分泌肿瘤的 CT 及 MRI 表现有一定特征性， 肿瘤的大小、 形态、 位置、 内部成分、 强化程度、 胰胆管的扩张及转移等特征对术前 PNET 病理分级的预测具有重要价值。

关键词: 关键词： 胰腺肿瘤, 体层摄影术, X 线计算机, 磁共振成像, 病理学, 临床, 胰腺神经内分泌肿瘤

Abstract: Abstract: Objective To analyze the CT and MRI features of high and low grade pancreatic neuroendocrine tumors (PNET). Methods The clinical, imaging and pathological data of 32 patients with PNET collected from January 2011 to May 2017 were retrospectively analyzed. There were 21 cases with low grade PNET (G1, G2) and 11 cases with high grade PNET (G3). All of the 32 patients were performed with CT or MRI examination before operation, and pathology analysis was confirmed after operation. The imaging findings were compared between high- and low-grade PNET groups. Results In 32 patients, 31 cases were with single lesion, only 1 case with two lesions. Twelve cases were in G1, 9 cases in G2 and 11 cases in G3. Lesion location: 10 lesions were in pancreatic head, 10 lesions in body and 12 lesions in tail. Lesion shape: 19 lesions were round, and 13 lesions were irregular. Lesion internal components: 16 cases were solid lesion, 14 cases were as a cystic- solid lesion and 2 cases were cystic lesion. Calcification was found in 5 cases. Pancreatic bile tract dilatation was found in 3 cases (both were G3). The other organs or lymph gland metastasis were found in 4 cases (both were G3), in which 2 cases were with liver metastasis, 2 cases with lymphatic metastasis. High-grade PNET was usually located in the head of the pancreas, tumors were large in size, and the shape was often irregular, showing low enhancement on enhanced CT or MRI, which can be accompanied by dilation of the pancreatic bile tract and other organs or lymph node metastasis. Conclusion High-grade and low-grade PNET shows certain imaging characteristics, such as tumor diameter, shape, location, internal components, enhancement pattern, pancreatic bile tract dilatation and metastases features, which has important value for the forecast of preoperative pathology grade of PNET.

Key words: Key words: pancreatic neoplasms, tomography, X-ray computed, magnetic resonance imaging, pathology, clinical, pancreatic neuroendocrine tumors