摘要
目的:探讨胰腺神经内分泌肿瘤(pancreatic neuroendocrine neoplasm,pNEN)的超声造影(contrast-enhanced ultrasound,CEUS)图像特征与病理学分级的相关性。方法:回顾并分析49例经穿刺或手术后病理学检查证实的pNEN的术前CEUS图像,观察并记录超声声像图表现及CEUS增强—消退改变,并将CEUS表现与病理学分级作相关性分析。结果:最终病理学检查结果显示15例病灶为神经内分泌瘤(neuroendocrine tumor,NET)G1,23例病灶为NET G2,11例病灶为NET G3或神经内分泌癌(neuroendocrine carcinoma,NEC)。所有病灶在常规灰阶超声检查时都表现为低回声实质团块。动脉期NET G1病灶以整体均匀增强为主(11/15,73.3%),NET G3/NEC以不均匀增强为主(8/11,72.7%;P<0.05)。从增强程度来看,NET G1、NET G2、NET G3/NEC病灶在CEUS动脉期多数表现为高或等增强(93.3%、82.6%及72.7%);在CEUS静脉期,NET G1病灶以高增强或等增强为主(14/15,93.3%),而44.1%的NET G2和NET G3/NEC病灶呈低增强改变(P<0.05)。CEUS延迟期,NET G1病灶以高增强或者等增强为主(13/15,86.7%),而67.6%(23/34)的NET G2和NET G3/NEC病灶呈低增强表现(P<0.05)。结论:pNEN的CEUS表现与其病理学分级具有一定的关联。CEUS静脉期或延迟期始终呈整体均匀高增强或等增强的病灶提示为NET G1。
Objective:To explore the correlations between contrast-enhanced ultrasound(CEUS)features of pancreatic neuroendocrine neoplasm(pNEN)and their pathological grades.Methods:In this retrospective study,49 cases of operation or biopsy and histopathological proven pNEN lesions were included.Ultrasound and CEUS examinations were performed preoperatively.Using histopathological results as final gold standard,imaging features of ultrasound and CEUS were analyzed and compared among neuroendocrine tumor(NET)G1,NET G2,NET G3 or neuroendocrine carcinoma(NEC)groups.Results:Final histopathological results included 15 cases of NET G1,23 cases of NET G2 and 11 cases of NET G3/NEC.During the arterial phase of CEUS,most NET G1 were homogeneously enhanced(11/15,73.3%),while most NET G3/NEC lesions were heterogeneously enhanced(8/11,72.7%;P<0.05).As for the enhancement degree,the majority of NET G1,NET G2,NET G3/NEC lesions were hyper or iso-enhanced during the arterial phase.During the venous phase,most NET G1 lesions showed hyper or iso-enhancement(14/15,93.3%),meanwhile 44.1%of the NET G2 and NET G3/NEC lesions showed hypo-enhancement.Most NET G1 lesions were hyperenhanced or iso-enhanced during the late phase(13/15,86.7%),meanwhile 67.6%(23/34)of the NET G2 and NET G3/NEC lesions were hypo-enhanced.Conclusion:CEUS enhancement features of pNEN related to their pathological grades.Homogeneous hyperor iso-enhancement during the late phase of CEUS might indicate the possible diagnosis of NET G1.
作者
杨道辉
韩序
张琪
于凌云
邱艺杰
董怡
楼文晖
王文平
YANG Daohui;HAN Xu;ZHANG Qi;YU Lingyun;QIU Yijie;DONG Yi;LOU Wenhui;WANG Wenping(Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Pancreatic Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《肿瘤影像学》
2021年第4期237-244,共8页
Oncoradiology
基金
国家自然科学基金(82071942)
上海市科学技术委员会医学引导类项目(18411967200)
上海市卫生和计划生育委员会科研课题计划(201840215)
上海市浦江人才计划(2020PJD008)
上海申康医院发展中心促进市级医院临技能与临床创新能力三年行动计划(SHDC2020CR4060,SHDC2020CR1031B)。
关键词
胰腺神经内分泌肿瘤
超声造影
病理学分级
术前预测
Pancreatic neuroendocrine neoplasm
Contrast-enhanced ultrasound
Pathological grade
Preoperative prediction
