摘要
目的:胰腺神经内分泌肿瘤(pancreatic neuroendocrine tumors,p NET)在临床上较罕见,本研究对比分析p NET病灶与胰腺导管腺癌(pancreatic ductal adenocarcinoma,PDAC)的超声造影(contrastenhanced ultrasound,CEUS)表现,旨在揭示CEUS在p NET术前诊断及鉴别诊断中的价值。方法:回顾性分析了18例p NET患者共18个病灶常规超声及超声造影的增强方式和特点,并与55例PDAC病灶相比较。所有的病灶都经手术及病理证实。结果:p NET病灶平均大小为(36.6±18.1)mm,PDAC病灶平均大小为(37.1±15.2)mm。注射超声造影剂后,所有p NET在动脉期均表现为高增强(n=11,61.1%)或等增强(n=7,38.9%);静脉期p NET病灶多表现为高增强(33.3%,6/18)或等增强(50.0%,9/18)。延迟期27.8%(5/18)的病灶表现为高增强,50.0%(9/18)的病灶表现为等增强。而多数(76.4%)PDAC病灶始终表现为不均匀低增强(P<0.05)。超声造影诊断p NET的符合率为94.4%,灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为77.8%、100.0%、94.5%、100.0%和93.1%。结论:CEUS有助于术前诊断及鉴别诊断p NET。
Objective： Pancreatic neuroendocrine tumors（p NET） are very rare in clinic. In our retrospective study, the contrast-enhanced ultrasound（CEUS） features of p NET and pancreatic ductal adenocarcinoma（PDAC） were compared to evaluate the preoperative diagnosis value of CEUS. Methods： In our retrospective study, 18 cases of p NET patients（18 lesions） and 55 cases of PDAC patients（55 lesions） were included. Ultrasound and CEUS imaging features were investigated and compared. All the lesions were final proved by operation and histopathological results. Results： On conventional grayscale ultrasound, the average diameter of p NET lesions was（36.6±18.1） mm, and（37.1±15.2） mm for PDAC lesions. After injection of contrast agents, all p NET lesions showed hyper-enhancement（n=11, 61.1%） or iso-enhancement（n=7, 38.9%） during arterial phase, 33.3%（6/18） lesions showed hyper-enhancement and 50.0%（9/18） lesions showing iso-enhancement during venous phase. About 27.8%（5/18） lesions showed hyperenhancement and 50.0%（9/18） lesions showed iso-enhancement during late phase. However, most（76.4%） PDAC lesions showed hypo enhancement during all CEUS phases（P〈0.05）. The diagnostic accuracy of CEUS in p NET was 94.4%（17/18）, with 77.8% sensitivity, 100.0% specificity, 94.5% accuracy, 100% positive predictive value and 93.1% negative predictive value respectively. Conclusion： CEUS is helpful in preoperative diagnosis and differential diagnosis of p NET.
作者
杨道辉
张琪
于凌云
董怡
曹佳颖
毛枫
王文平
YANG Daohui;ZHANG Qi;YU Llngyun;DONG Yi;CAO Jiaying;MAO Feng;WANG Wenping(Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Shanghai Institute of Imaging Medicine,Shanghai 200032,China)
出处
《肿瘤影像学》
2018年第3期145-149,共5页
Oncoradiology
基金
国家自然科学基金(81571676)
上海市医学领军人才项目
关键词
超声造影
胰腺神经内分泌肿瘤
胰腺癌
鉴别诊断
Contrast-enhanced ultrasound
Pancreatic neuroendocrine tumors
Pancreatic ductal adenocaxcinoma
Differential diagnosis
