摘要
目的 总结胰腺神经内分泌肿瘤 CT表现的特点及良恶性鉴别诊断方法。方 法 选择我院2010年1月-2015年10月期间 收治36例经手术病理证实的胰腺神经内分 泌肿瘤患者作为研究对象,均行螺旋CT三 期扫描,总结胰腺神经内分泌肿瘤的CT表 现及良恶性肿瘤鉴别方法。结果 功能性 胰腺神经内分泌肿瘤的CT平扫以等密度结 节为主,增强扫描强化明显,无功能胰腺 神经内分泌肿瘤多体积大,多见完整包膜 结构,动脉期以不均匀或环形增强为主。 实性患者动脉期强化形式均为中度或明 显强化,囊性/囊实性患者则以轻度强化 为主54.6%(6/11),差异有统计学意义(P <0.05)。结论 功能性与无功能胰腺神经 内分泌肿瘤的CT表现均存在一定特征,可 帮助临床诊断提供有用信息,且良恶性的 鉴别诊断也有一定规律可循,利于提高诊 断准确性,实现早期确诊。
Objective To summarize the characteristics of CT findings of pancreatic neuroendocrine tumors and differential diagnosis of benign and malignant tumors. Methods 36 patients with pancreatic neuroendocrine tumors confirmed by operation and pathology in our hospital from January 2010 to October 2015 were selected as the study object and all underwent spiral CT three phase scan. The CT findings of pancreatic neuroendocrine tumors and differential methods of benign and malignant tumors were summarized. Results The CT findings of functional pancreatic neuroendocrine tumors mainly were equal-density nodules and after enhanced scan, the enhancement was significant while those of non-functional pancreatic neuroendocrine tumors were large volume, visible complete envelope structures and in arterial phase, mainly was inhomogeneous or annular enhancement. The enhancement forms in arterial phase of patients with solid tumors were moderate or significant while of patients with cystic / cystic solid mainly were mild [54.6% (6/11)] (P<0.05). Conclusion The CT findings of functional and non-functional pancreatic neuroendocrine tumors have certain characteristics which can provide useful information for clinical diagnosis. Besides, the differential diagnosis of benign and malignant tumors also has certain rules to follow, which is beneficial to improve diagnostic accuracy and realize early diagnosis
【关键词】胰腺神经内分泌肿瘤;鉴别诊断;CT表现;三期扫描
【中图分类号】R657.5
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.04.027
前言
胰腺神经内分泌肿瘤(PNEN)在恶性肿瘤中较为少见,在胰腺肿瘤 中所占百分率约为3%[1],随着影像学技术的进步,检出率呈现升高趋 势。WHO将PNEN分为神经内分泌瘤、神经内分泌癌、混合性腺神经内分 泌癌等类型,且治疗方案与肿瘤分级及分期均有直接关系[2],因而对 于PNEN患者,通过有效影像学检查手段尽早明确诊断利于预后改善, 意义重大。近年来临床已经出现胰腺神经内分泌肿瘤影像表现的相关 报道,但CT表现及特征分析的报道则较为缺乏。本文以我院收治胰腺 神经内分泌肿瘤患者为例,总结胰腺神经内分泌肿瘤CT表现的特点及 良恶性鉴别诊断方法,为该病的临床诊断提供参考,现报道如下。
中国CT和MRI杂志
第14卷, 第 4 期
2016年04月
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