【摘要】 目的探讨多病灶胰腺神经内分泌肿瘤(PNETs)CT和MRI影像学特征。方法选取2014年3月至2018年5月间应城市人民医院收治的70例经病理证实的PNETs患者进行回顾性分析,对多病灶行CT和MRI检查,分析病灶的影像学表现,包括位置、直径、数量、形态、密度、内部结构、其它脏器转移及胰管形态等。结果 G1级20个病灶平扫呈低密度比重高,G2级22个病灶呈等密度比重高,G1级病灶强化峰值位于静脉期的例数多于G2级,两者比较,差异均有统计学意义(均P<0.05)。G1级PNETs病灶CT发现形态规则的比重为85.0%,呈圆形或类圆形,边界相对清晰;G2级病灶规则的比重为54.5%,病灶有分叶,边界较模糊,两者比较,差异有统计学意义(P<0.05)。G2级病灶中有38.9%引起胆管和胰管扩张,高于G1级病灶;G1级PNETs病灶MRI发现形态规则比重为83.3%,高于G2级的55.6%,差异均有统计学意义(均P<0.05)。G1和G2级病灶在强化峰值的时间上比较,差异有统计学意义(P<0.05)。多病灶在T2WI表现出不同程度的高信号,两分级病灶的DWI弥散受限比重较高,可提高病灶的检出率。G1和G2级病灶影像学检查直径比较,多数G1级病灶直径小于G2级。结论多病灶PNETs在CT和MRI下的强化方式、病灶形态和胆胰管有无扩张等特征,可为PNETs临床病理分级提供可行依据。更多还原

【Abstract】 Objective To analyze the CT and MR imaging features of pancreatic neuroendocrine tumor(PNETs).Methods The imaging and clinical data of 70 patients with PNETs confirmed by pathology at Yingcheng People’s Hospital from March 2014 to May 2018 were selected and proportion retrospectively analyzed.Multiple lesions were examined by CT and MRI,and the imaging features of the lesions were analyzed,including location,size,quantity,shape,density,internal structure,other organs metastasis,and pancreatic duct morphology.Results Twenty-two lesions of grade G1 showed a high proportion of low density through CT plain scan,while 22 lesions of grade G2 showed high proportion of isodensity.The number of G1 lesions at CT and MRI at the venous phase was more than that of G2(all P<0.05).38.89% of the G2 lesions caused the dilation of the bile duct and the pancreatic duct,which was obviously higher than that of the G1 level.MRI found 83.3% lesions were grade G1 PNETs,which was higher than 55.6% of grade G2(P<0.05).Most lesions showed different high signial on T2 weighted image(T2 WI) and the proportion of diffusional limitation was high for the two grades lesions,which can help improve the detection rate of lesions.When comparing lesion diameters between G1 and G2,lesion diameters were smaller for G1 than for G2 mostly.Conclusion The enhancement pattern,lesion shape and dilatation of biliary and pancreatic ducts in multiple lesions PNETs under CT and MRI can provide a feasible basis for clinical pathological grading of PNETs.更多还原