摘要
目的探讨原发性肝脏神经内分泌癌的多种影像学表现,以期提高其影像学诊断水平。方法回顾性分析经病理证实的5例肝脏神经内分泌癌患者资料,分析其多排探测器计算机断层摄影(multi-detector computerized tomography,MDCT)、MRI及数字减影血管造影(digital subtraction angiography,DSA)表现。结果 5例患者中,多发4例,表现为≥2个病变,1例为单发。MDCT检查病灶平扫呈边界清楚低密度,其内见不规则坏死区,增强为"快进慢出"强化方式,动脉期病灶多呈花环状及斑片状强化,门脉期病灶呈向心性强化,延迟期呈等或稍高密度,坏死区无强化;MRI检查示肿瘤呈分叶状、可见分隔影,T1WI为低及稍低信号,T2WI及DWI为高或稍高信号混合,T2WI呈类"灯泡征",强化方式同MDCT;DSA显示动脉期肿瘤明显染色,肝动脉供血。结论肝脏神经内分泌癌在多种影像学上有一定的特征性,综合MDCT和MRI影像学表现有助于诊断。
Objective To investigate the imaging features on multi-detector computerized tomography（ MDCT）,MRI and digital subtraction angiography（ DSA） of primary hepatic neuroendocrine carcinoma. Methods A retrospective analysis was performed on 5 patients with neuroendocrine carcinoma diagnosed pathologically. Imaging features on MDCT,MRI and DSA were analyzed. Results Among 5 cases,4 cases showed ≥2 lesions and 1 case showed a single lesion.Abdominal MDCT revealed multiple well-circumscribed,heterogeneous and hypodense masses with irregular necrotic area and showed a ＂ fast-in,slow-out＂ enhancement pattern. MDCT showed flower ring and patchy constant enhancement during arterial phase,and centripetal enhancement in portal phase and contrast wash-out,peripheral and irregular slight enhancement during delayed phase. MRI revealed lobulated masses with separate shadow,slightly low signal on T1 WI,mixed high or slightly higher signal on T2 WI and DWI. T2 WI showed classic ＂ light bulb＂ sign. MRI showed the same enhancement pattern as MDCT. DSA angiography demonstrated multiple hypervascular tumor staining stoves with sharp edges in arterial phase. Conclusion The imagings on MDCT,MRI and DSA of primary hepatic neuroendocrine carcinoma demonstrate some special characteristics,and the highest diagnostic sensitivities may be achieved by a combination of different imaging modalities.
出处
《实用肿瘤杂志》
CAS
2015年第1期44-48,共5页
Journal of Practical Oncology
