原发性肝脏神经内分泌癌的MRI表现与病理对照研究-论文.pdf

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1、放射学实践2013年12月第28卷第12期RadiolPractice，Dec2013，Vol28，No．121267●腹部影像学原发性肝脏神经内分泌癌的MRI表现与病理对照研究陈财忠，李若坤，蒋杰，强金伟，饶圣祥，赵婧，曾蒙苏【摘要】目的：探讨原发性肝脏神经内分泌癌(PHNEC)的MRI表现及其病理基础，旨在提高其影像诊断水平。方法：回顾性分析8例经手术病理证实的PHNEC患者的MRI资料，分析其影像特点并与病理对照。结果：1例为单发结节型，病灶边界清晰，TwI上呈低信号、T。wI上呈稍高信号，DWI上呈显著高信号，增强后动脉期有明显强化，门脉期及延迟

2、期呈等信号；7例为巨块结节型，表现为巨大主灶伴周边卫星结节灶。主灶信号于TwI上呈低信号、TzwI上呈稍高信号，DWI上呈显著高信号，增强后动脉期有明显强化，门脉期对比剂迅速廓清，延迟期周边可见环形强化的包膜影。卫星结节灶数目不等，大小不一，TwI上呈低信号、TwI上呈稍高信号，DWI上呈显著高信号，呈环形强化或均匀强化。结论：PHNEC的MRI表现具有一定特征性，常表现为不均质巨块结节型富血供病灶伴门脉期对比剂快速廓清及延迟期包膜强化。【关键词】肝肿瘤；神经内分泌肿瘤；磁共振成像；病理学【中图分类号1R445．2；R735．7【文献标识码】A【文章编号

3、】1000—0313(2013)12—126704MRIfindingsofprimaryhepaticneuroendocrinecarcinoma：correlationwithpathologyCHENCai—zhong，LIRuo—kun，JIANGJie，eta1．DepartmentofDiagnosticRadiology，ZhongshanHospital，FudanUniversity，ShanghaiMedicalImagingIn—stitute，Shanghai200032，P．R．China[Abstract]Objective

4、：ToinvestigatetheMRIfindingsofprimaryhepaticneuroendocrinecarcinoma(PHNEC)andtheircorrelationwithpathologicfeature；．Methods：MRimagesof8PHNECpatientsconfirmedbyhistopathologywereret—rospectivelyanalyzed．Themorphologicalcharacteristicsanddynamicenhancementpatternswereevaluated，andc

5、orrelationoftheseimagingfindingswithhistopatho1ogywasstudied．Results：Onecaseshowedsolitarynodulewithhomogeneroushy—pointensityonTlWIandhyperintersityonT2WIanddiffusion-weightedimaging(DWI)．Theremaining7casesappearedaswell—defineddominantmasseswithvariablesatellitenodules．Thedomin

6、antmassesdemonstratedheterogeneoushypointen—sityonTlWIandhyperintersityonT2WI，whichwasassociatedwithinternalnecrosis，cysticdegenerationandfibrosisbyhistopathology．Thedominantmassesshowedmarkedenhancementinarterialphaseandrapidwashoutinportalvenousphaseafteradministrationofcontras

7、tmedia．Sixcasesdemonstratedcapsularenhancementinequilibriumphase．．Thesatel—litenodulesshowedhypointensityonTlWIandmarkedhyperintersityonT2WIandDW1withhomogeneousorrim-likeen—hancement．Conclusion：PHNECappearsasmultiple，well—defined，hypervascularlesionswithrapidwashoutandcapsularen

8、—hancementondynamiccontrastenhancementim