CAJ | 학술논문

目的：探讨胰腺神经内分泌肿瘤（NETP）的 CT 表现及其诊断价值。方法：回顾性分析经手术病理证实的28例 NETP 患者的临床和影像资料，运用 Spearman 等级相关分析比较不同级别肿瘤间的强化差异，运用 Fisher 精确检验法比较功能性和非功能性肿瘤间强化程度的差异。结果：28例中功能性 NETP 5例，非功能 NETP 23例；根据 WHO 分级， G1级15例，G2级9例，G3级4例；肿瘤以实性成份为主25例（8例为完全实性），囊性为主3例；18例肿瘤实性部分在增强扫描动脉期呈明显强化，其余10例肿瘤强化程度类似于胰腺或者略低于胰腺；增强扫描动脉期，15例 G1级 NETP 中肿瘤实质部分明显强化13例，9例 G2级肿瘤中明显强化4例；4例 G3级肿瘤中仅1例表现为明显强化；增强扫描动脉期，5例功能性 NETP 中肿瘤实质部分明显强化3例，23例非功能性 NETP 中15例明显强化；肿瘤病理分级越高，表现为明显强化的可能性越小（γs＝－0．752，P ＜0．05），功能性和非功能性肿瘤间的强化差异无统计学意义（P ＝0．601＞0．05）。结论：NETP 的 CT 表现具有一定的特征性，CT 有助于肿瘤的术前评价，指导临床制订治疗方案。
목적：탐토이선신경내분비종류（NETP）적 CT 표현급기진단개치。방법：회고성분석경수술병리증실적28례 NETP 환자적림상화영상자료，운용 Spearman 등급상관분석비교불동급별종류간적강화차이，운용 Fisher 정학검험법비교공능성화비공능성종류간강화정도적차이。결과：28례중공능성 NETP 5례，비공능 NETP 23례；근거 WHO 분급， G1급15례，G2급9례，G3급4례；종류이실성성빈위주25례（8례위완전실성），낭성위주3례；18례종류실성부분재증강소묘동맥기정명현강화，기여10례종류강화정도유사우이선혹자략저우이선；증강소묘동맥기，15례 G1급 NETP 중종류실질부분명현강화13례，9례 G2급종류중명현강화4례；4례 G3급종류중부1례표현위명현강화；증강소묘동맥기，5례공능성 NETP 중종류실질부분명현강화3례，23례비공능성 NETP 중15례명현강화；종류병리분급월고，표현위명현강화적가능성월소（γs＝－0．752，P ＜0．05），공능성화비공능성종류간적강화차이무통계학의의（P ＝0．601＞0．05）。결론：NETP 적 CT 표현구유일정적특정성，CT 유조우종류적술전평개，지도림상제정치료방안。
Objectire:To analyze the CT manifestations of neuroendocrine tumor of pancreas (NETP)and the diag-nostic value of CT.Methods:The CT images and clinical data of 28 patients with NETP proved by surgery and pathology were retrospectively analyzed by two radiologists.All the tumors were graded as G1 to G3 according to the WHO classifica-tion in 2010.Spearman′s rank correlation analysis was performed to compare enhancement degree with pathological grade of NETP,Fisher's exact test was used to analyze the difference of enhancement degree between functional and non-functional NETP.Results:Of all 28 cases,there were functional NETPs in 5 cases,and non-functional NETPs in 23 cases.The tumors of 15 cases were graded as G1,9 cases as G2,and 4 cases as G3.Most of the tumors consisted of solid and cystic compo-nents,most of the components were solid in 25 cases (the tumor was completely solid in 8 cases),or cystic in 3 cases.After contrast-enhancement,the solid parts of tumor showed obvious enhancement in 18 cases,showed mild enhancement similar to that of normal pancreatic parenchyma in 10 cases.In arterial phase of contrast enhanced scan,13 of 14 G1-NETPs showed obvious enhancement,4 of 9 G2-tumors showed obvious enhancement,1 of 4 G3-tumors showed obvious enhancement.3 of 5 functional NETPs showed obvious enhancement,15 of 23 non-functional tumors showed obvious enhancement.The en-hancement of tumors with higher grade showed a probable trend of decrease (γs=-0.752,P <0.05),there was no statistic difference in enhancement between functional and non-functional tumors (P =0.601>0.05).Conclusion:NETPs have some characteristic CT features which can be helpful to evaluate the malignant degree of tumor before operation,and provide more information for the postoperative treatment planning.