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胃及十二指肠神经内分泌肿瘤的CT表现

作者:于乐林 尚海龙 刘 冬 李振凯 沈海林

所属单位:苏州大学附属第一医院影像中心(江苏 苏州 215006)

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摘要

目的 探讨胃及十二指肠神经内 分泌肿瘤的CT表现。方法 回顾性分析7例 行CT平扫+增强检查且经手术病理证实的 胃及十二指肠神经内分泌肿瘤CT表现,重 点观察病灶的大小、形态、位置、平扫及 强化CT值及强化方式、边界及病灶与周围 组织关系、有无淋巴结转移特点。结果 5 例胃NET病灶主体位于胃体4 例,位于胃窦 1例,其中4例位于胃小弯侧,2例十二指 肠NET病灶主体位于十二指肠降段1例,位 于十二指肠水平段1例。病灶长径在1.5- 13.2cm之间,CT平扫病灶多(6例) 表现为 胃肠道内边界光整的软组织肿块。CT平扫 及双期动态增强扫描平均CT值分别35HU, 77HU,91HU。胃部及十二指肠内分泌肿瘤 强化方式为渐近性强化。结论 胃及十二 指肠神经内分泌肿瘤的CT表现比较典型, CT动态增强扫描对其诊断及鉴别诊断有重 要的价值。

Objective To explore the dynamic contrast-CT presentations of neuroendocrine tumors of the Gastric and duodenal. Methods Dynamic contrast-CT findings of 7 histologically proved neuroendocrine tumors of the Gastric and duodenal were analyzed retrospectively. All the 7 cases underwent plain and Double-phase dynamic CT enhancement scan. Results Among 5 cases of gastric, 4 cases were located in Gastric body and 1 case was located in gastric antrum, among this 4 cases were located in the lesser curvature. Among 2 cases of duodenal, one was located in descending part of duodenum and the other was located in the third portion of duodenum, Masses long axis of Seven lesions were between 1.5 and 13.2cm. The average CT values of the non-contrast CT scan and double phases dynamic CT scan were 35HU, 77 HU, and 91 HU respectively. Conclusion Neuroendocrine tumors of the Gastric and duodenal has some typical features on CT images, and it has a high value in the diagonosis and differential diagnosis.

【关键词】胃神经内分泌肿瘤;十二指肠 神经内分泌肿瘤;计算机体层成像增强扫描

【中图分类号】R735.2

【文献标识码】A

【DOI】10.3969/j.issn.1672- 5131.2017.01.033

前言

胃肠道神经内分泌肿瘤(neuroendocrine tumors,NET)是来源于 胃肠道黏膜或黏膜下功能各不相同的内分泌细胞的低度恶性肿瘤,临 床较为罕见,因为其临床症状不典型,误诊率较高,笔者收集经手术 病理或穿刺活检证实的7例胃及十二指肠NET患者临床及影像学资料, 以提高对该病的认识。