胰腺内分泌肿瘤的MSCT、MRI诊断

目的分析胰腺内分泌肿瘤（Pancreatic endocrine tumors,PETs）的CT及MRI表现,提高对PETs的影像学诊断水平。方法回顾性分析17例经病理证实的PETs的MSCT及MRI资料;MSCT采用常规平扫和薄层三期动态增强扫描（动脉期、胰腺期和门脉期）;MRI扫描序列包括SET1WI、FST1WI、FSET2WI/FS、FIESTA、弥散成像（DWI）及动态增强,并测定ADC值。结果 17例患者共发现21个病灶,胰头部5个,胰颈部3个,胰体部7个,胰尾部6个,其中1例在胰头及体尾部共3个病灶,胰体和胰尾各1个病灶2例。MSCT平扫呈低或稍低密度（12/21）、等密度（9/21）,肿瘤内见钙化（6/21）。增强动脉期或胰腺期明显强化（18/21）,逐渐强化（3/21）。13例行MRI平扫,呈长或稍长T1及长或稍长T2信号（8/14）,等T1等T2信号（6/14）,DWI肿瘤呈明显高信号,ADC值（1.124±0.252）×10-3mm2/s,与文献报道胰腺癌的ADC值比较,具有统计学意义（P〈0.05）;9例行动态增强动脉期或胰腺期肿瘤呈明显强化（6/9）,轻度强化（2/9）,无明显强化（1/9）;均匀强化（4/9）,不均匀强化（2/9）,边缘环形强化（3/9）。结论 MSCT和MRI,特别是动态增强扫描及DWI,对PETs诊断及鉴别诊断具有重要价值。

MSCT and MRI Diagnosis Pancreatic Endocrine Tumors

Objective To analysis CT and MR! findings of pancreatic endocrine ru- mors （PETs）, and improve the diagnostic level of PETs imaging. Methods A retrospec- tive analysis of MSCT and MRI data of 17 patients with PETs being pathologically confirmed were carried out, and conventional plain scantling, enhanced dynamic scan- ning of thin layer three phases （arterial phase, pancreatic phase and portal venous phase） with MSCT, MRI scanning sequence including SET IWI, FSTI WI,FSET2WI/ FS, FIESTA. diffusion-weighted imaging （ DWI ） and dynamic enhanced, were perforlned, and deternfination of ADC value were detected. Results Of 17 patients with PETs 21 lesions were found, including 5 in head of pancreas,3 in pancreatic neck ,7 in pancreatic body. 6 in the tail of pancreas, of which there was I cases with 3 lesions in head and body and tail of pancreas, and 2 cases with I lesion in body and tail respectively. MSCT scanning showed a low or slightly low density （12/21）, equal density （9/21 ）. calcification within the tumor （6/21 ）. Obvious enhancement on slrength ened arterial phase or pancreatic （ 18/21 ）, gradually strengthening （3/21 ）. The routine MRI scanning in 13 cases exhibited a long or sligbtly longer TI and T2 signal （8/14）, equal T I and T2 signal （6/1 4）,and DWl of tumor showed a high signal, and the ADC value （1. 124 ±0.252）×10-3mm2/s comparing with pancreatic ADC value reported in the literature was provided wilh strongly statistical significance （P〈0.05） and with dynamic enhancement on arterial phase or pancreatic the tumor in 9 cases showed significantly enhancement （6/9）, mild （2/9）, no significant （ 1/9）, homogeneous （4/9）. inhomogeneous （2/9）, edge ring （3/9）. Conclusion MSCT and MRI, especially dy- namic enhanced scanning and DWI, have an important value for diagnosis and differ- ential diagnosis of PETs.