摘要
目的:探讨CT灌注和MRI增强诊断CT三期增强阴性胰腺神经内分泌肿瘤的临床应用。方法:对临床均具有典型Whipple三联征10例患者行CT灌注和MRI检查(动态增强及DWI),同时收集外院或本院的胰腺CT三期扫描检查结果。结果:三种影像诊断方法分析P均<0.05,有统计学差异;胰腺CT三期扫描:1例定位(10%),未定性。CT灌注:7例定位(70%)、7例定性(70%)。MRI增强:9例定位(90%)、5例定性(50%);DWI:10例定位(100%);9例病例经过手术证实为胰岛素瘤,1例肝穿刺诊断为胰腺恶性神经内分泌肿瘤伴肝内多发转移。胰岛素瘤均为功能性,时间密度曲线平均达峰时间17s,平均峰值162±53.83HU,平均血流量208±57.24ml/(min·100ml),恶性肿瘤延迟达峰。结论:对CT三期增强阴性神经内分泌肿瘤诊断,CT灌注和MRI增强检查明显优于CT三期扫描,同时CT灌注可评估肿瘤血供。
Purpose： To explore the clinical value of the perfusion CT and the enhanced MRI in the diagnosis of pancreatic neuroendocrine tumor which was negative in the three-phase enhanced CT. Methods： Ten patients who were with clinical Whipple＇s triplet syndrome were undergone perfusion CT and MRI （dynamic enhanced and DWI）. Meanwhile,the three-phase enhanced CT data of them in our hospital or other hospitals were collected. Results： The difference of the diagnostic efficacy between the three imaging diagnostic methods was with statistical significance （P〈0.05）. The three-phase enhanced CT of pancreas： 1 case was with localization diagnosis （10%）, but not with qualitative result; 7 cases were diagnosed with localization and qualitative results （70%） by perfusion CT; 9 cases were with localization diagnosis （90%）, and 5 cases were with qualitative diagnosis （50%） by enhanced MRI; 10 cases were with localization diagnosis （100%）; 9 cases was confirmed with insulinoma after surgery, and 1 case was proven with malignant pancreatic neuroendocrine tumor with intrahepatic multiple metastases by the liver punctuation. Insulinomas were all functional, and the average peak time of time-density curve was 17 s, the average peak CT value was 162±53.83HU, the average blood flow was 208±57.24ml/ min/100ml, and the peak time of malignant tumors was delayed. Conclusion： For the diagnosis of pancreatic neuroendocrine tumors which were negative in the three-phase enhanced CT, CT perfusion and enhanced MRI are superior to three-phase enhanced CT. In addition, the blood supply of tumor can be evaluated by CT perfusion.
作者
谭正武
任克
缪琪
郑玉丽
柴瑞梅
TAN Zheng-wu REN Ke MIAO Qi ZHENG Yu-li CHAI Rui-mei(： Department of Radiology, The First Affiliated Hospital of China Medical University ： Department of Radiology, Union Hospital Tongji Medical College Huazhong University of Science and Technology)
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2017年第5期483-489,共7页
Chinese Computed Medical Imaging
基金
辽宁省科学技术计划项目No.2012225013~~
关键词
CT灌注
磁共振成像
胰腺神经内分泌肿瘤
CT perfusion
Magnetic resonance imaging （MRI）
Pancreatic neuroendocrine tumor
