原发性十二指肠神经内分泌肿瘤的CT表现

目的 探讨原发性十二指肠神经内分泌肿瘤的CT表现.方法 回顾性分析经病理证实的10例十二指肠神经内分泌肿瘤的多层螺旋CT表现.结果 病灶多位于十二指肠近段(十二指肠球部3例、降部6例、水平部1例);6例表现为腔内息肉状肿块,4例表现为壁内肿块;最大径1.6～6.5 am,平均2.3 cm.CT平扫呈等或稍低密度,平均CT值为41HU;密度均匀者7例,不均匀者3例;所有病灶均未见钙化.增强检查动脉期肿块明显强化,门脉期和平衡期强化程度逐渐降低,均匀强化者6例,不均匀强化者4例,三期增强扫描平均CT值分别为95 HU、83 HU、65 HU.肝内外胆管扩张2例;腹腔及腹膜后淋巴结肿大4例;胰腺受累1例;术后复发并侵犯血管1例.结论 十二指肠神经内分泌肿瘤三期动态增强CT表现有一定特征性,发现早期明显强化对诊断具有较高价值.

CT performances of primary neuroendocrine tumors of the duodenum

Objective To investigate the CT findings of primary duodenal neuroendocrine tumors. Methods In 10 patients with duodenal neuroendocrine tumors confirmed by pathology, the features on MSCT were retrospectively analyzed. Results Most duodenal neuroendocrine tumors located in the proximal duodenum (3 in the bulb, 6 in the second portion and 1 in the third portion). Six patients had focal intraluminal polypoid masses and 4 had mural masses. The tumor diameter ranged from 1.6 to 6.5 cm with a mean value of 2.3 cm. Slightly low density or isodensity was found on pre-contrast CT with an average CT values of 41 HU, homogenous in 7 patients and heterogenous in 3 patients. No calcification was found in all the patients. During three-phase of intravenous contrast-enhanced CT, the lesions showed obvious enhancement at arterial phase and loss of enhancement at portal venous and delayed imaging, with homogenous enhancement in 6 patients and heterogenous enhancement in 4 patients. The average CT values of three-phase was 95 HU, 83 HU, 65 HU, respectively. Other findings included intrahepatic and extrahepatic bile duct dilatation in 2 patients, abdominal cavity and retroperitoneal lymph node enlargement in 4 patients, pancreatic gland encroachment in 1 and vessel encroachment in 1 patient of recurrence. Conclusion Three-phase dynamic CT findings of primary duodenal neuroendocrine tumors are relatively specific, and early-phase contrast enhancement shows high value for the diagnosis of this disease.