胃肠道神经内分泌肿瘤CT表现与病理分级对照分析
Comparative Analysis on CT Findings and Pathological Grades of Gastrointestinal Neuroendocrine Neoplasms

目的：分析胃肠道神经内分泌肿瘤(GI-NENs) CT表现与病理分级。方法：回顾性分析2013年5月至2018年7月我院经手术病理证实为GI-NENs的40例患者临床资料，评估其CT表现，并依据病理分级分为G1 + G2组、G3组，分析两组CT影像学特征。结果：40例患者中病理证实为G1级、G2级、G3级分别11例、5例、24例；CT可见28例呈局限性肠壁增厚，26例为均匀等密度，7例肿块中可见小斑片状坏死低密度区，2例为高密度出血灶，增强扫描动脉期明显强化34例，轻度强化6例，静脉期强化减退，部分病变侵犯浆膜、肠系膜淋巴结肿大、发生肝转移；G1 + G2组肿瘤直径小于G3组，经壁侵犯、坏死囊变、邻近组织侵犯、淋巴结转移率低于G3组(P < 0.05)，两组边界、生长方式、远处器官转移、强化方式比较差异无统计学意义(P > 0.05)。结论：GI-NENs有其特征性CT表现，且CT对判断肿瘤侵犯范围与转移、评估病理分级等有重要价值，值得在临床推广实践。
Objective: To analyze the CT findings and pathological grades of gastrointestinal neuroendocrine neoplasms (GI-NENs). Methods: The clinical data of 40 patients with GI-NENs confirmed by surgery and pathology in the hospital from May 2013 to July 2018 were retrospectively analyzed. According to CT findings and pathological grades, they were divided into G1 + G2 group and G3 group. The CT imaging features of both groups were analyzed. Results: In the 40 patients, there were 11 cases, 5 cases and 24 cases pathologically confirmed with G1, G2, and G3. CT showed there were 28 cases with localized thickening of intestinal wall, 26 cases with even isometric density. There were 7 cases with small patchy-like necrosis low-density areas in mass, 2 cases with high-density hemorrhage lesions. There were 34 cases with enhanced enhancement during arterial phase by enhancement scan, 6 cases with mild enhancement. The enhancement during venous stage was reduced. There were partial lesions invasion serosa and mesenteric lymphadenopathy, appearing liver metastasis. The tumor diameter of G1 + G2 group was smaller than that of G3 group, while transmural invasion, necrotic cystic change, adjacent tissue invasion and metastasis rate of lymph node were lower than those of G3 group (P < 0.05). There was no significant difference in the borders, growth modes, distant organ metastasis or strengthening mode between the two groups (P > 0.05). Conclusion: There are characteristic CT findings of GI-NENs. CT is of important value in judging the range of tumor invasion and metastasis and evaluating pathological grade.