摘要
目的：探讨胸腺神经内分泌肿瘤（TNETs）的CT影像特征,提高其CT诊断水平。方法：回顾性分析20例TNETs患者的临床及CT影像资料,其中男17例,女3例,平均年龄52岁。所有病例均经组织病理学及免疫组化进行病理分型,并行胸部CT平扫及增强检查,分析其CT影像学特征（主要包括大小、形状、密度、强化程度、有无坏死、转移和邻近结构侵犯等）。结果：组织病理学亚型：典型类癌2例（10%）,不典型类癌4例（20%）,小细胞癌4例（20%）,大细胞神经内分泌癌1例（5%）,未明确病理学亚型9例（45%）。根据CT危险度分级标准,4级15例（75%）,3级4例（20%）,2级1例（5%）。CT影像学特征：不规则形18例（90%）;内部密度不均匀14例（70%）,瘤体内显示钙化9例（45%）,囊变坏死11例（55%）;增强后多为不均匀性轻~中度强化,其中轻度强化8例（40%）,中度强化11例（55%）,仅有1例胸腺典型类癌出现显著强化。肿瘤多沿纵隔血管间隙生长,19例（95%）出现纵隔结构侵犯,13例（65%）不同程度侵犯包绕纵隔大血管,9例（45%）存在上腔静脉癌栓,12例（60%）可见纵隔肿大淋巴结,1例侵犯胸骨。结论：TNETs的CT表现具有一定特征性,多沿大血管间隙浸润性生长,常伴发上腔静脉癌栓形成。CT对TNETs的鉴别诊断和术前评估具有重要价值。
Objective：To study the clinical and CT features of thymic neuroendocrine tumors （TNETs） for improving CT diagnostic value. Methods：The clinical and CT data of 20 patients （17 males and 3 females with a mean age of 52 yrs） with TNETs confirmed by histopathology and immunohistochemistry were collected and retrospectively reviewed for the purposes of this study. The CT findings were analyzed,including tumor size, shape, density, degree of enhancement, with or without necrosis,metastasis and invasion of adjacent structures. Results： According to the histological and immunohisto- chemical results, there were 2 cases （ 10% ） of typical carcinoid, 4 cases （20% ） of atypical carcinoid, 4 cases （20 % ） of small cell carcinoma,one case （5 %） of large cell neuroendocrine carcinoma, and 9 cases （45% ） of undetermined pathological sub- type. According to CT aggressive risk classification criteria, 15 （75 % ） patients were categorized in Grade IV, 4 （20 %） in Grade Ⅲ , and 1 （5 %） in Grade Ⅱ. CT imaging features ： irregular shape in 18 cases （90 % ）, heterogeneous density in 14 cases （70 %）,intratumoral calcification in 9 cases （45 ~）,and necrotic or cystic change in 11 cases （55 %）. Mild to moderate enhancement after contrast injection was found in most TNETs,including mild enhancement in 8 cases （40 %） ,moderate en- hancement in 11 cases （55%）,intensive enhancement only in one patient with typical carcinoid. Most TNETs exhibited an infiltrative growth pattern along the mediastinal large vascular space, with invasion to the adjacent structures in 19 cases （ 95 % ）, invasion to the mediastinal large vessels in 13 cases （65 % ）, superior vena cava tumor thrombosis in 9 cases （45 % ）, and mediastinal lymphadenopathy in 12 cases （60 %）. There was invasion by direct extending to sternum in one case. Conclusion..TNETs have certain characteristic CT findings. Most of tumors show an infiltrative growth pattern along mediastinal large vascul
出处
《放射学实践》
北大核心
2016年第12期1186-1190,共5页
Radiologic Practice
基金
陕西省社会发展科技攻关项目(2016SF-211)
第四军医大学唐都医院科技创新发展基金基础医学研究项目(2015JCYJ010)
