期刊文献+

肝脏神经内分泌肿瘤的超声造影表现及与病理分级的对照研究 预览 被引量:1

Contrast-enhanced ultrasonography(CEUS) characteristics of hepatic neuroendocrine neoplasm (hNEN) correlation with pathological grade
在线阅读 下载PDF
分享 导出
摘要 目的:分析肝脏神经内分泌肿瘤的超声造影表现特征,探讨超声造影对肝脏神经内分泌肿瘤的诊断价值及病理分级预测价值。方法:选取2009年9月—2017年9月就诊于复旦大学附属中山医院的34例肝脏神经内分泌肿瘤患者,其中25例由肝脏穿刺活检或手术病理证实,9例由原发灶病理结合增强CT/MRI检查证实。所有患者术前均行超声造影检查。根据病理结果,参照世界卫生组织(World Health Organization,WHO)2010年消化系统神经内分泌肿瘤分级标准,将肿瘤病理分级分为G1、G2和G3级。G2与G3级病灶间定量指标的比较采用独立样本t检验或Mann-Whitney U检验,定性指标的比较采用Fisher精确概率法。结果:34例肝脏神经内分泌肿瘤病理分级为G1级0例,G2级21例,G3级13例;病灶平均开始增强时间、达峰时间、消退时间分别为(16.2±4.7)、(22.0±5.5)和(42.9±23.4)s;在动脉期增强过程中,79.4%(27/34)的病灶表现为整体增强,20.6%(7/34)的病灶表现为向心性增强;增强达峰时,61.8%(21/34)的病灶呈均匀增强,26.5%(9/34)的病灶呈不均匀增强,11.8%(4/34)的病灶呈环形增强;门静脉期,所有病灶均表现出不同程度的减退,其中32.3%(11/34)的病灶呈轻度减退,67.7%(23/34)的病灶呈明显减退;延迟期所有病灶均呈明显减退。与肝实质增强情况相比,病灶的增强-减退模式可表现为"快进快出"、"同进快出"及"慢进快出"3种。其中52.9%(18/34)的病灶呈"快进快出",38.3%(13/34)的病灶呈"同进快出",8.8%(3/34)的病灶呈"慢进快出"。G2与G3级病灶间增强-减退模式的差异有统计学意义(P〈0.05),而增强时间、增强方式、峰值表现和减退程度的差异无统计学意义(P〉0.05)。结论:肝脏神经内分泌肿瘤的超声造影表现具有一定特征,病灶的增强-减退模式对肝脏神经内分泌肿瘤病理分级的预测有一 Objeative: To analyze the contrast-enhanced ultrasonography(CEUS) characteristics of hepatic neuroendocrine neoplasm(h NEN) and to investigate its clinical values of CEUS in predicting pathological grading of h NEN. Methods: From Sep. 2009 to Sep. 2017, images of CEUS were analyzed retrospectively in 34 cases of h NEN confirmed by pathology and imaging in Zhongshan Hospital, Fudan University. The CEUS characteristics including enhancement time, enhancement pattern, manifestations of peak time, washout degree of enhancement and wash in-wash out model of lesions were observed by two ultrasound doctors who had at least five-year working experience. These 34 cases were divided into 3 grades(G1, G2 and G3)according to World Health Organization 2010 classification of gastroenteropancreatic NEN. The differences in CEUS characteristics among deifferent grades were compared. Results: The average time to start, time to peak and time to decline were(16.2±4.7),(22.0±5.5) and(42.9±23.4) s respectively. Two patterns of enhancement were observed during the enhancement progression: global enhancement and centripetal enhancement. Of the 34 h NEN cases, 79.4%(27/34) of lesions showed global enhancement and 20.6%(7/34) of lesions showed centripetal enhancement. As for the manifestations of peak time, 61.8%(21/34) of lesions showed homogenously enhanced pattern, while 26.5%(9/34) of lesions showed inhomogenously enhanced pattern and 11.8%(4/34) of lesions showed rim-like enhanced pattern. The enhancement of all lesions washed out at portal venous phase with different degree. Of the 34 h NEN cases, 32.3%(11/34) of leisons showed mild washout and 67.7%(23/34) of lesions showed remarkable washout. All lesions showed remarkable washout at delay phase. Compared with liver parenchyma, 52.9%(18/34) of h NEN lesions showed "fast in and fast out", 38.3%(13/34) of h NEN lesions showed "synchronous in and fast out" and 8.8%(3/34) of h NEN lesions showed "slow
作者 汪瀚韬 王文平 张小龙 徐亚丹 张炜彬 韩红 朱正 董怡 WANG Hantao1,2, WANG Wenping1,2, ZHANG Xiaolong2, XU Yadan2, ZHANG Weibin2, HAN Hone1, ZHU Zheng3, DONG Ni1 (1. Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China; 2. Shanghai Institute of Imaging Medicine, Shanghai 200032, China; 3. The First Hospital of Taicang, Taicang 215400, Jiangsu Province, China)
出处 《肿瘤影像学》 2018年第3期134-139,共6页 Shanghai Medical Imaging
基金 国家自然科学基金项目(81571676) 上海市医学领军人才项目
关键词 肝肿瘤 神经内分泌肿瘤 超声造影 Liver neoplasm Neuroendocrine neoplasm Contrast enhanced ultrasound
作者简介 通信作者:王文平E-mail:puguang61@126.com
  • 相关文献

参考文献4

二级参考文献61

  • 1吕明德 ,徐辉雄 ,刘广健 ,徐作峰 ,谢晓燕 ,郑艳玲 ,梁瑾瑜 .应用低机械指数连续超声造影鉴别诊断肝脏局灶性病变[J].中国超声医学杂志,2005,21(6):440-443. 被引量:67
  • 2Yaov JC,Hassan M,Phan A,et al.One hundred years after "carcinoid ":epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States.J Clin Oncol,2008,26(18):3063-3072. 被引量:1
  • 3Yao JC,Shah MH,Ito T,et al.Everolimus for advanced pancreatic neuroendocrine tumors.N Engl J Med,2011,364(6):514-523. 被引量:1
  • 4Raymond E,Dahan L,Raoul JL,et al.Sunitinib malate for the treatment of pancreatic neuroendocrine tumors.N Engl J Med,2011,36(6):501-513. 被引量:1
  • 5Kl(o)ppel G,Couvelard A,Perren A,et al.ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors:towards a standardized approach to the diagnosis of gastroenteropancreatic neuroendocrine tumors and their prognostic stratification.Neuroendocrinology,2009,90 (2):162-166. 被引量:1
  • 6Klimstra DS,Modlin IR,Adsay NV,et al.Pathology reporting of neuroendocrine tumors:application of the Delphic consensus process to the development of a minimum pathology data set.Am J Surg Pathol,2010,34(3):300-313. 被引量:1
  • 7Bosman FT,Carneiro F,Hruban RH,et al.WHO classification of tumours of the digestive system.Lyon:IARC Press,2010. 被引量:1
  • 8Oberndorfer S.Karzinoide tumoren des dunndarms.Frankf ZPatrol,1907,1:426-432. 被引量:1
  • 9Williams ED,Siebenmann RE,Sobin LH.Histological typing of endocrine tumours.Geneva:World Health Organization,1980. 被引量:1
  • 10Hamilton SR,Aaltonen LA.World Health Organization classification of tumours.Pathology and genetics of tumours of the digestive system.Lyon:IARC Press,2000. 被引量:1

共引文献246

同被引文献7

引证文献1

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈