胰腺无功能神经内分泌肿瘤的多层螺旋CT增强特征

摘要

Objective To evaluate the double-phase enhanced MSCT features of non-functional pancreatic neuroendocrine tumor (NFPNET). Methods The radiological data of 24 patients with NFPNET, pathologically diagnosed in our hospitals from Jan 2009 to Dec 2015, were retrospectively analyzed. The plain, enhanced arterial and portal phase CT values in each tumor lesions were measured, and the absolute values in the arterial and portal phase enhancement range were further calculated. Then they were statistically compared with those absolute values in the pancreas parenchyma enhancement range, and the enhancement method, situation of peripheral viscera invasion or dis-tant metastasis of NFPNET were also analyzed. Results The absolute values of arterial phase enhancement in the NFPNET and pancreas pa-renchyma were (59. 08 ± 34. 14) HU and (53. 82 ± 15. 35) HU, respectively, with no significant difference between them (P>0. 05). The absolute values of portal phase enhancement in the NFPNET and pancreas parenchyma were ( 48. 05 ± 22. 80 ) HU and ( 39. 37 ± 11. 57 ) HU, respectively, and significant difference was found between them (P<0. 05). Among the 24 NFPNET cases, 10 cases had higher arteri-al phase enhancement degree in the tumor lesions than that in the pancreatic parenchyma, and 14 cases had higher portal phase enhancement degree in the tumor lesions. Additionally, 3 cases presented with flocculent enhancement, 9 cases with circular enhancement, and 7 cases with wall nodular enhancement. The peripheral viscera invasion and distant metastasis were found in 8 cases. Conclusion Compared with pancreatic parenchyma, NFPNET may be relatively hyper-vascular tumors in the portal phase. The pancreatic dynamic enhanced scanning could be used as an important means for the diagnosis of NFPNET.%目的 探讨胰腺无功能性神经内分泌肿瘤(NFPNET)的多层螺旋CT(MSCT)双期增强特征.方法 回顾性分析2009年1月至2015年12月由上海市徐汇区大华医院及交通大学附属瑞金医院病理证实的24例NFPNET患者的影像学资料,分别测量肿瘤病灶平扫、增强动脉期及增强门脉期CT值,计算肿瘤的动脉期及门脉期的强化幅度绝对值并与胰腺实质强化幅度绝对值进行统计学比较;并对肿瘤的强化方式、是否具有周边脏器受侵或远处转移进行统计.结果 增强动脉期NFPNET与胰腺实质强化绝对值分别为(59.08±34.14)、(53.82±15.35)HU,两者比较差异无统计学意义(P>0.05);门脉期NFPNET与胰腺实质增强绝对值分别为(48.05±22.80)、(39.37±11.57)HU,两者差异有统计学意义(P<0.05).NFPNET强化程度超过胰腺实质,动脉期有10例,门脉期有14例;3例片絮状强化,9例环形强化,7例壁结节样强化,8例有周边侵犯或远处转移.结论 胰腺动态增强扫描是诊断NFPNET的重要手段,NFPNET门脉期相比胰腺实质表现为相对富血供.