摘要
目的探讨胰腺神经内分泌肿瘤的MRI表现,着重分析肿瘤与主胰管及邻近结构的细微征象。方法收集我院2000年1月~2014年1月经手术病理证实的胰腺神经内分泌肿瘤患者26例和胰腺腺癌58例进行研究。所有病例在行1.5 T MRI扫描后综合各个序列图像观察肿瘤的部位、形态、大小、数目、边缘、平扫及动态增强后信号特征,着重探讨肿瘤与主胰管、十二指肠环、胰周大血管的关系。结果 26例胰腺神经内分泌肿瘤术前MRI共发现27个病灶,肿瘤最大径为4.2±2.6 cm(0.8~9.0 cm),主胰管最大径为2.1±1.1 mm(1~4 mm);肿块>3 cm的囊实性肿瘤并向胰外突出生长者占33.3%(9/27)。76.9%(20/26)的胰腺神经内分泌肿瘤病例见"主胰管绕道征/主胰管偏移征"、胰腺癌未见此征象(x^2=58.558,P<0.05);增强扫描胰腺神经内分泌肿瘤有多种强化方式,胰周大血管受压移位且未侵犯者占38.5%(10/26)。结论胰腺单发边缘清晰的肿块、动态增强呈富血供肿瘤、见到"主胰管绕道征/主胰管偏移征"且主胰管管径在正常范围内、胰周大血管受推移而不被侵犯者,需考虑胰腺神经内分泌肿瘤。
ObjectiveTo investigate MRI features of pancreatic neuroendocrine tumor.Methods MRI of 84 patients with pathologically confirmed pancreatic neuroendocrine tumors（26） and pancreatic cancer（58）was reviewed. The number, location, size, shape, border, signal intensities and contrast enhancement of the tumors as well as the relationship between the tumors and the pancreatic ducts and adjacent structures were analyzed.Results 27 lesions were identified in 26 patients with pancreatic neuroendocrine tumors. The maximum diameters of the tumors and main pancreatic ducts were 4.2±2.6（0.8-9.0）cm and 2.1±1.1（1-4）mm, respectively. 33.3%（9/27）of the lesions were mixed solid and cystic masses 〉3cm protruding from the pancreas. The pancreatic duct was displaced in 76.9%（20/26）. Contrast enhancement pattern was variable in 27 lesions and peri-pancreatic vascular compression or displacement without invasion was demonstrated in 38.5%（10/26）.Conclusion Hypervascular tumor with displacement and no dilation of the main pancreatic duct, peri-pancreatic vascular compression or displacement and no invasion on MRI is characteristics of pancreatic neuroendocrine tumor.
出处
《影像诊断与介入放射学》
2014年第5期392-398,共7页
Diagnostic Imaging & Interventional Radiology
关键词
胰腺
神经内分泌肿瘤
主胰管
磁共振成像
主胰管绕道征
Pancreas
Pancreatic neuroendocrine tumor
Pancreatic duct
Magnetic resonance imaging
Bypass sign of pancreatic duct
