超声造影诊断胰腺神经内分泌肿瘤的临床应用价值

杨道辉; 张琪; 于凌云; 董怡; 曹佳颖; 毛枫; 王文平

doi:10.19401/j.cnki.1007-3639.2018.03.004

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超声造影诊断胰腺神经内分泌肿瘤的临床应用价值

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- 超声造影诊断胰腺神经内分泌肿瘤的临床应用价值
- Clinical value of contrasted-enhanced ultrasound in diagnosis of pancreatic neuroendocrine tumors
- 肿瘤影像学 2018年27卷第3期页码：145-149
- 作者机构：
  
  1. 复旦大学附属中山医院超声科,上海,200032
  2. 上海市影像医学研究所,上海,200032
- 作者简介：
- 基金信息：
  
  国家自然科学基金（81571676）;上海市医学领军人才项目。
- DOI：10.19401/j.cnki.1007-3639.2018.03.004
  中图分类号：
- 网络出版：2018-07-26，
  
  纸质出版：2018-07-26
- 稿件说明：
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杨道辉,张琪,于凌云,等. 超声造影诊断胰腺神经内分泌肿瘤的临床应用价值[J]. 肿瘤影像学, 2018, 27(3): 145-149 https://doi.

org/10.19401/j.cnki.1007-3639.2018.03.004
杨道辉,张琪,于凌云,等. 超声造影诊断胰腺神经内分泌肿瘤的临床应用价值[J]. 肿瘤影像学, 2018, 27(3): 145-149 https://doi. DOI： 10.19401/j.cnki.1007-3639.2018.03.004.

org/10.19401/j.cnki.1007-3639.2018.03.004 DOI：

摘要

目的：

胰腺神经内分泌肿瘤（pancreatic neuroendocrine tumors，pNET）在临床上较罕见，本研究对比分析pNET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pNET术前诊断及鉴别诊断中的价值。

方法：

回顾性分析了18例pNET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：

pNET病灶平均大小为（36.618.1）mm，PDAC病灶平均大小为（37.115.2）mm。注射超声造影剂后，所有pNET在动脉期均表现为高增强（

=11，61.1%）或等增强（

=7，38.9%）；静脉期pNET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（

0.05）。超声造影诊断pNET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pNET。

Abstract

Objective:

Pancreatic neuroendocrine tumors (pNET) are very rare in clinic. In our retrospective study

the contrast-enhanced ultrasound (CEUS) features of pNET and pancreatic ductal adenocarcinoma (PDAC) were compared to evaluate the preoperative diagnosis value of CEUS.

Methods:

In our retrospective study

18 cases of pNET patients (18 lesions) and 55 cases of PDA

C 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 pNET lesions was (36.618.1) mm

and (37.115.2) mm for PDAC lesions. After injection of contrast agents

all pNET lesions showed hyper-enhancement (

=11

61.1%) or iso-enhancement (

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 (

0.05). The diagnostic accuracy of CEUS in pNET 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 pNET.

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