CAJ | 학술논문

目的：探讨原发胰腺神经内分泌肿瘤的MSCT表现。方法回顾性分析11例经病理证实的胰腺原发神经内分泌肿瘤的CT表现，包括病灶位置、大小、密度、强化特点及与周围血管脏器及胆总管下段及胰管的关系等，是否有低血糖及黄疸等临床症状。结果11例经手术证实的神经内分泌肿瘤病灶（位于胰头4例、胰颈1例、胰体2例、胰尾4例），病灶大小为1.5～10 cm，平均3.9 cm。11例病人中，功能性神经内分泌肿瘤5例，无功能性神经内分泌肿瘤6例。11例CT平扫检查时病灶呈等低密度，9例增强病人其中7例神经内分泌肿瘤动脉期及静脉期均呈显著强化，静脉期病灶强化程度较动脉期稍减低，与胰腺实质相类似，2例因肿瘤体积较大，内部缺血坏死区无明显强化。结论神经内分泌肿瘤的MSCT具有特征性表现，尤其是多期增强CT检查为鉴别诊断提供更多信息。通过对肿瘤强化方式、病灶与周围器官、组织的关系观察及病灶有无远处转移，对临床拟定合理的治疗方案提供有价值的参考标准，提高胰腺神经内分泌肿瘤的治愈率。
목적：탐토원발이선신경내분비종류적MSCT표현。방법회고성분석11례경병리증실적이선원발신경내분비종류적CT표현，포괄병조위치、대소、밀도、강화특점급여주위혈관장기급담총관하단급이관적관계등，시부유저혈당급황달등림상증상。결과11례경수술증실적신경내분비종류병조（위우이두4례、이경1례、이체2례、이미4례），병조대소위1.5～10 cm，평균3.9 cm。11례병인중，공능성신경내분비종류5례，무공능성신경내분비종류6례。11례CT평소검사시병조정등저밀도，9례증강병인기중7례신경내분비종류동맥기급정맥기균정현저강화，정맥기병조강화정도교동맥기초감저，여이선실질상유사，2례인종류체적교대，내부결혈배사구무명현강화。결론신경내분비종류적MSCT구유특정성표현，우기시다기증강CT검사위감별진단제공경다신식。통과대종류강화방식、병조여주위기관、조직적관계관찰급병조유무원처전이，대림상의정합리적치료방안제공유개치적삼고표준，제고이선신경내분비종류적치유솔。
Objective To discuss the MSCT features of primary pancreatic neuroendocrine tumors. Methods In 11 patients with pancreatic neuroendocrine tumors conifrmed by pathology, the features on MSCT were retro-spectively analyzed. The study included the location, size, density, strengthening characteristics of lesions, rela-tionship with neighbor organs and pancreatic duct, appearing the hypoglycemia and jaundice or not. Results The 11 cases were proved by pathologic results which are all pancreatic neuroendocrine tumors (4 cases in the head of pancreas, 1 case in the neck of pancreas, 2 cases in the body of pancreas, 4 cases in the tail of pancreas). The di-ameter of the tumors were approximate between 1.5 cm and 10 cm, the average diameter were 3.9 cm. There were 5 functional neuroendocrine tumors and 6 nonfunctioning neuroendocrine tumors in these 11 cases. We could observe in the CT plain scan images, lesions all showed low density;7 cases of the 9 contrast-enhanced patients were signiifcantly enhanced in double-phase MSCT images;but in the venous phase the enhanced extent of the tu-mors which were similar to the normal pancreas, were lower than the enhanced extent in the arterial phase. 2 cases didn’t have the enhancement because of no rich blood supply. Conclusion The CT ifndings were characteristic to diagnose the pancreatic neuroendocrine tumors especially the biphasic contrast enhancement can provide more information to diagnose neuroendocrine tumors. In the CT images, by observing the enhancement way of neuroen-docrine tumors, the relationship with neighbor organs and tissue, the metastasis or not, the clinicians can settle on reasonable and effective treatment to improve the cure rate of the pancreatic neuroendocrine tumors.