肝外胆管神经内分泌肿瘤：影像学及临床特征

Neuroendocrine neoplasms of the extrahepatic bile duct: radiologic and clinical characteristics.

作者信息

Hong Nurhee, Kim Hyoung Jung, Byun Jae Ho, Kim So Yeon, Kim Kyoung Won, Kim Jin Hee, Hong Seung-Mo

机构信息

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, Korea.

出版信息

Abdom Imaging. 2015 Jan;40(1):181-91. doi: 10.1007/s00261-014-0191-0.

DOI:10.1007/s00261-014-0191-0

PMID:25008023

Abstract

PURPOSE

To retrospectively identify the radiological and clinical features of neuroendocrine neoplasms of the extrahepatic bile duct.

MATERIALS AND METHODS

Institutional review board approval was obtained. Between August 2003 and August 2013, 11 patients (range 41-79 years) who had undergone surgery in our institution for neuroendocrine neoplasms of the extrahepatic bile duct were identified. Clinical features (symptoms, laboratory finding, and medical history) were reviewed. A pathologist reviewed the pathology of 11 patients. CT (n = 11), MRI (n = 10), and PET/CT (n = 8) were reviewed by two radiologists in consensus. They were blinded to the clinical features and pathology report. The tumor location was assessed on CT and was classified as occurring in the common hepatic duct, cystic duct, and common bile duct. The tumor shape was assessed in ten patients using MRI and in one patient using CT. The shape was classified as nodular, intraductal-growing, and periductal-infiltrating type. The FDG activity on PET/CT was also evaluated. Correlation of image findings with pathology was made by a radiologist who didn't participate in the image analysis.

RESULTS

There were five men and six women and their median age was 65 years. On pathology examination, seven patients had neuroendocrine carcinoma (64%), three had mixed adenoneuroendocrine carcinoma (27%), and one had neuroendocrine tumor (9%). CT showed that the tumors were located in the common bile duct in seven patients (64%), the common hepatic duct in two (18%), and the cystic duct in two patients (18%). Five tumors were classified as nodular (45%), five as intraductal-growing (45%), and one as periductal-infiltrating type (9%). PET/CT showed increased FDG activity, ranging from 2.7-15.9, in eight patients with neuroendocrine carcinoma.

CONCLUSION

The most common location of neuroendocrine neoplasms of the extrahepatic bile duct is the common bile duct. Most of them are nodular or intraductal-growing type.

摘要

目的

回顾性分析肝外胆管神经内分泌肿瘤的影像学及临床特征。

材料与方法

获得机构审查委员会批准。2003年8月至2013年8月期间，在本机构接受手术治疗的11例（年龄范围41 - 79岁）肝外胆管神经内分泌肿瘤患者被纳入研究。回顾临床特征（症状、实验室检查结果及病史）。一名病理学家对11例患者的病理进行了复查。两名放射科医生共同对11例患者的CT、10例患者的MRI及8例患者的PET/CT进行了复查。他们对临床特征及病理报告不知情。通过CT评估肿瘤位置，并将其分为发生于肝总管、胆囊管及胆总管。利用MRI对10例患者及1例患者利用CT评估肿瘤形态。形态分为结节型、导管内生长型及导管周围浸润型。同时评估PET/CT上的FDG活性。由未参与图像分析的放射科医生对图像表现与病理结果进行相关性分析。

结果

5例男性，6例女性，中位年龄65岁。病理检查显示，7例为神经内分泌癌（64%），3例为混合性腺神经内分泌癌（27%），1例为神经内分泌瘤（9%）。CT显示，7例患者肿瘤位于胆总管（64%），2例位于肝总管（18%），2例位于胆囊管（18%）。5个肿瘤为结节型（45%），5个为导管内生长型（45%），1个为导管周围浸润型（9%）。8例神经内分泌癌患者的PET/CT显示FDG活性增加，范围为2.7 - 15.9。