肝脏原发性神经内分泌肿瘤影像学表现及病理对照

目的 探讨肝脏原发性神经内分泌肿瘤(PHNET)的CT、MRI表现及其病理基础.方法 收集经手术病理证实的PHNET 14例(14例均行CT检查,其中9例行MR检查),分析病灶的CT、MRI表现,探讨形成影像表现的病例基础.结果 PHNET呈单发(8例)或多发结节(5例),弥漫性全肝分布1例.CT平扫呈低密度,1例可见液-液平面病理为内部出血;动脉期呈结节状或环形强化,1例呈弥漫性强化,门静脉期或延迟期强化减低.MRI呈长T1长T2信号,出血呈短T1短T2信号,强化形式与CT相同.随病理分级的提高,病灶由G1单发实性-G2实性或囊实性-G3弥漫性分布或出现肝内转移.扩散加权成像(DWI)呈扩散受限改变.结论 CT、MRI能够显示出PHNET的影像学特殊表现和组织学特征.

Primary hepatic neuroendocrine tumor:the radiologic features and correlation with pathology

Objective To investigate CT and MRI findings of primary hepatic neuroendocrine tumor (PHNET) and the correlation with the pathology.Methods 14 patients with pathologically confirmed PHNET were analyzed retrospectively.All the patients underwent CT and 9 patients underwent MR.The CT and MRI findings were analyzed and the correlation with pathology was evaluated.Results Single lesion was found in 8 cases, and multiple nodular lesions in 5 cases, diffuse nodular lesions of the liver in 1 case.The lesions showed low density on CT images in all patients, and liquid-liquid level was visible in 1 lesion associated with internal bleeding.Contrast-enhanced CT in arterial-phase phase showed nodular or marginal ring enhancement in 13 cases, diffuse enhancement in 1 case, and in portal venous and delayed phases the enhancement of lesion subsequently decreased, compared with surrounding liver parenchyma.MRI showed hypointensity on T1WI and hyperintensity on T2WI, intralesional hemorrhage appeared as hyperintensity on T1WI and hypointensity on T2WI, and the enhancement pattern of MRI was similar to that of CT.With the increase of pathology grade,G1 presented as a single solid nodule,G2 as solid or cystic-solid nodules, and G3 as diffuse nodules or intrahepatic metastasis was found.The lesions showed hyperintensity on DWI.Conclusion CT and MRI can show characteristic appearances of PHNET and its certain histological characteristics.