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CT Diagnosis and differential diagnosis of the Pancreatic Endocrine Tumor<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
宋琦 方文强 潘自来 张欢 陈克敏
上海第二医科大学附属瑞金医院放射科
Qi SONG, Wen-qiang FANG, Zi-lai PAN, Huan ZHANG, Ke-min CHEN
Department of Radiology, Ruijin Hospital, Shanghai
Second Medical Univisity, Shanghai 200025,China
Abstract
Objective：To evaluate the value of multiphase CT with thin-slice to localize the pancreatic endocrine tumors preoperateively.
Methods：Prospective interpretations of multiphase helical CT scans were reviewed in 65 patients who had surgically and pathologically confirmed PETs, CT scans were retrospectively reviewed to compare and analyze the enhancement characteristics, tumor detection in each phase of enhancement.
Results：Eighty-one percent (53/65) of tumors were identified on CT prospectively. Most tumors were hyperdense on at least one phase (n=60), one tumor were hypoattenuating, and five were isodense. PETs were most conspicuous on the arterial and pancreatic phase.
Conclusion：CT characteristic findings play important role in the diagnosis of PET which should be differentiated from pancreatic cystadenoma, solid-psudopapillary tumor and metastases, gastrointestinal stromal tumor, ectopic pheochromocytoma and neurogenic neoplasma.
Key words：Pancreatic endocrine tumor Computed Tomography Differental Diagnosis
胰腺内分泌肿瘤（pancreatic endocrine tumor, PET）为起源于胰腺内分泌细胞的肿瘤，并非常见，文献报道每年发病率为5人/百万人[1]，但它却是胰腺肿瘤中比较重要的一类。PET可分为功能性和无功能性两大类，功能性PET根据其所分泌的特定激素而命名，分别称为胰岛素瘤、胃泌素瘤、胰高糖素瘤、生长抑素瘤、血管活性肠肽瘤、胰多肽瘤、神经降压素瘤、类癌及GRF瘤等，功能性PET由于微小的肿瘤能分泌激素而在早期就有临床表现，早期发现微小肿瘤的位置和数目至今是一个临床难题。而无功能性PET不具特异性的内分泌功能紊乱的临床症状，常在进展期才被发现，良性肿瘤表现为胰腺的巨大包块，恶性则常有肝、肺或淋巴结的转移，但由于其缓慢生长的特性，要找到原发灶有时也非易事。动态增强CT和MR是术前诊断PET的常见影像学检查技术，近年来，螺旋CT在胰腺疾病诊断中的运用已取得了很大的进展，盖因其能在一次造影剂注射后多期成像，优化了增强效果，提高了病变的检出率。本研究回顾了我院运用胰腺薄层螺旋CT分期扫描技术术前定位PET的的资料，评估其对PET的诊断价值，探讨肿瘤的CT表现和特征，旨在提高术前对PET的诊断和治疗水平。 |
