【摘要】 目的探讨肝脏原发性神经内分泌癌(NEC)的CT诊断及鉴别诊断。方法回顾性分析2007年7月~2016年6月经病理证实的7例肝脏原发性NEC患者的临床、病理及影像资料并总结分析其CT表现。结果 7例患者中单发4例,多发3例,表现为单个较大主灶伴多发子灶。肿瘤最大径4.8~17.3cm,4例边界清楚,3例边界欠清。7例密度均欠均匀,可见不同程度囊变坏死。动脉期7例肿瘤实质部分轻中度不均匀强化,门脉期持续强化,其中3例强化范围增加,逐渐向内填充。肿瘤血管显影3例,瘤体边缘包膜样强化2例。侵犯胆囊壁2例;肝内胆管扩张3例;肝门区、后腹膜淋巴结肿大4例。结论肝脏原发性NEC的CT表现具有一定特征,CT检查对该病诊断与鉴别有一定的价值,确诊仍需依赖病理。更多还原

【Abstract】 Objective To investigate the CT diagnosis and the differential diagnosis of primary hepatic neuroendocrine carcinoma. Methods CT imaging and clinicopathological data of 7 cases of primary hepatic NEC proved by pathology between July2007 and June 2016 were analyzed retrospectively. Results Of the 7 cases,4 cases showed single lesion,and the remaining 3 cases showed single large tumor with multiple satellite nodules. The maximum diameter of the tumors ranged from 4. 8 to 17. 3 cm.Four tumors had well-defined margins,while three tumors had relatively ill-defined margins. Uneven mass density and different sizes of necrotic cysts were found in 7 tumors. The enhanced CT showed the solid components of all tumors with mild to moderate enhancement in arterial phase and continuous enhancement in the portal venous phase. In three patients,the enhanced area was enlarged in the portal venous phase. Of the 7 cases,3 cases showed tumor vessels in arterial phase and 2 cases demonstrated capsular enhancement in venous phase. 2 cases presented with direct invasion into adjacent gallbladder. 3 cases oppressed hepatic duct and bile duct,the remote intrahepatic bile duct was dilatation. 4 cases showed enlarged lymph nodes of hepatic hilum and posterior peritoneum. Conclusion CT may show the imaging characteristics of the primary hepatic neuroendocrine carcinoma,which is helpful for the diagnosis and differential diagnosis. However,the definite diagnosis still depends on histopathological examination.更多还原