Objective To explore the MRI characteristics and therapy of non-functioning pancreatic neuroend-ocrine neoplasms (NF-pNENs) and to improve the diagnostic and therapeutic level. Methods The MRI and clinical data of 11 cases of NF-pNENs proved by pathology were analyzed retrospectively. Results All 11 cases were single tumor. Seven cases were viewed as oval while 4 cases were irregular and with lobes. Seven cases showed clear boundary while 4 cases showed local infiltration of adjacent tissue with undefined edge. The maximum diameter of the tumors was 23～137 mm and the mean value was 60.1 mm. There were 5 solid tumors, 5 solid-cystic tumors and 1 cystic tumor among the 11 cases. The unenhanced MRI of the solid area showed asymmetrical mild low signal on T1WI and mild high signal on T2WI, while the cystic area showed T1WI low and T2WI high signal. All tumors showed asymmetrical high signal on DWI. In the solid area, 7 cases showed obvious enhancement continuously, 3 cases showed moderate continuous enhancement and 1 case showed mild delayed enhancement on dynamic enhanced MRI. Complete or uncomplete membrane structure with obvious enhancement can be seen in the tumors of 9 cases. Three cases showed dilation of main duct of pancreas and/or central bile duct. Three cases were accompanied with liver metastasis and 2 cases were accompanied with retroperitoneal lymph node metastasis, and a small amount of ascites were presented in 2 cases. All the 11 cases underwent surgical treatment, and 9 of them obtained radical resection. Seven cases accepted systemic chemotherapy, while the rest 4 cases only received treatment of traditional Chinese medicine. All the 11 cases were followed from 6 to 63 months after surgery. Three cases died with mean survival time of 35.7 months and the rest 8 cases survived. Conclusion MRI can detect the pathological changes of NF-pNENs and it has important value for the diagnosis. Surgery is the main solution for NF-pNENs and radical resection should be performed as early as possibly once the diagnosis is confirmed.%目的 探讨无功能性胰腺神经内分泌肿瘤(non-Punctioning pancreatic neuroendocrine neoplasms,NF-pNENs)的MRI表现及治疗措施,提高诊疗水平.方法 回顾性分析11例经病理学证实的无功能性胰腺神经内分泌肿瘤的MRI及临床资料.结果 11例肿瘤均为单发,7例呈类圆形,4例呈不规则分叶状.7例边界较清晰,4例局部侵犯导致边界不清.肿瘤最大直径约23～137 mm,平均60.1 mm.其中实性5例,囊实性5例,囊性1例.MRI平扫肿瘤实性成分呈不均匀T1WI较低T2WI较高信号,囊变、坏死区为T1WI低T2WI高信号,DWI均为不均匀高信号.增强实性部分7例明显持续强化,3例呈中等持续强化,1例轻度延迟强化.9例见完整或不完整的包膜结构较明显强化,3例见胆总管和(或)主胰管增宽,3例肝脏转移,2例腹膜后淋巴结转移,2例腹腔少量积液.11例均经手术治疗,9例达到根治性切除.术后7例接受全身化疗,4例仅接受中医药治疗.术后随访6～63个月,3例死亡,平均生存时间35.7个月;8例仍存活.结论 MRI有利于反映NF-pNENs的病理学变化,对其诊断具有重要价值.手术切除是NF-pNENs的主要治疗手段,一旦确诊应争取根治性切除.
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