摘要
目的:总结原发性肝脏神经内分泌肿瘤(primary hepatic neuroendocrine neoplasm,PHNEN)的影像特点,以提高对该病的认识。方法:回顾性分析2006年4月至2017年4月8例经穿刺活检或手术病理证实的PHNEN患者的临床及影像学资料,对病灶位置、大小、形态、数目、密度、边界等进行综合性分析。结果:MSCT表现:7例为类圆形病灶,1例呈分叶状;肿瘤直径0.50～20.21 cm,平均为(10.25±9.96)cm;均表现为边界欠清或不清晰肿块,内可见小囊状低密度区,其中5例见局灶性出血,1例见血-液分层密度影。动脉期均见假包膜样强化,5例环形边缘轻度强化,3例边缘明显强化;延迟期5例病灶低密度区为渐进性强化,具有"反转强化"表现;病灶中心小片状低密度区均无强化,其中1例呈皂泡样蜂窝状强化。MRI表现(1例):T_2WI呈混杂高信号,T_1WI呈混杂低信号,见低信号包膜结构,弥散加权成像(diffusion weighted imaging,DWI)呈高信号,表观弥散系数(apparent diffusion coeffecient,ADC)图像呈低信号,增强后边缘早期强化,晚期持续强化。结论:PHNEN患者影像学表现具有一定特点,可为临床诊疗提供依据。
Objective To investigate the imaging features of primary hepatic neuroendocrine neoplasm(PHNEN).Methods A retrospective analysis was performed from April 2006 to April 2017.Eight patients with PHNEN proved by biopsy or surgery were included in the study.The imaging features of these patients were analyzed.Results Among all the cases,lesions showed round shape in 7 cases,and lobulated margin in 1 case.The range of tumor diameter was from 0.50 cm to 20.21 cm,and the tumor diameter was(10.25±9.96)cm on average.The eight cases showed low density masses with unclear boundary and cyst-like low-intensity areas,among which,5 ones had hemorrhagic focus,and 1 showed blood-liquid stratification.All the eight cases showed enhancement of tumor pseudocapsule in arterial phase,among which 5 showed lightly annular enhancement and 3 showed obvious annular enhancement.The lesion central areas of 5 cases had progressive enhancement in delayed phase.No enhancement was found in the low-density scutellate zone of the central part in 7 cases.One case showed honeycomb-like enhancement.One patient underwent MRI examination,and the lesion showed mixed intensity signal with hyperintensity signal in the majority on T2WI and with hypointensity signal in the majority on T1WI,and showed high signal intensity on DWI and low signal intensity on ADC map.Enhanced MRI scanning indicated annular enhancement in early phase and continuous enhancement of the central zone in delayed phase.Conclusion PHNEN has its certain imaging characteristics showing malignant performance,and can reflect histological features,which provides the basis for its clinical diagnosis and treatment.
作者
唐永强
石磊
舒俊
仲津漫
赵海涛
石明国
赵雪飞
TANG Yong-qiang;SHI Lei;SHU Jun;ZHONG Jin-man;ZHAO Hai-tao;SHI Ming-guo;ZHAO Xue-fei(Department of Radiology,the First Affiliated Hospital of the Fourth Military Medical University,Xi'an 710032,China)
出处
《医疗卫生装备》
CAS
2018年第12期57-61,共5页
Chinese Medical Equipment Journal
作者简介
唐永强(1981—),男,硕士,主治医师,主要从事腹部医学影像诊断方面的研究工作,E-mail:tangyq12315@139.com;通信作者:赵雪飞,E-mail:867514342@qq.com。
