Schwarze V, Marschner C, Grosu S, Rübenthaler J, Knösel T, Clevert D-A
Klinik und Poliklinik für Radiologie, Interdisziplinäres Ultraschallzentrum, Klinikum der Ludwig-Maximilians-Universität München, Campus Grosshadern, Marchioninistraße 15, 81377, München, Deutschland.
Pathologisches Institut, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland.
Radiologe. 2019 Nov;59(11):1002-1009. doi: 10.1007/s00117-019-00586-0.
Radiological and nuclear medical diagnostics play an important role in the work-up of patients with gastroenteropancreatic neuroendocrine tumors (GEP-NET). The sonographic examination, including contrast-enhanced examination, depicts an initial imaging modality to screen for NET. This report describes the sonomorphological behavior of ileal and pancreatic NET as well as hepatic metastases from NET.
CLINICAL/METHODICAL ISSUE: Sonographic evaluation of NET of the small intestine, pancreas and neuroendocrine hepatic metastases.
Contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI), unenhanced ultrasonography.
Contrast-enhanced ultrasound (CEUS).
CEUS supports unenhanced ultrasound in the detection of NET and the differential diagnosis of unclear lesions, and is more sensitive for liver metastases (sensitivity according to the literature, 99% vs. 68%) PRACTICAL RECOMMENDATIONS: CEUS allows initial evaluation of NET and differentiation of benign vs. malignant lesions. Nevertheless, CEUS cannot replace more elaborate imaging modalities like CT or MRI for thorough staging examinations.
放射学和核医学诊断在胃肠胰神经内分泌肿瘤（GEP-NET）患者的检查中发挥着重要作用。超声检查，包括增强检查，是筛查NET的初始影像学检查方法。本报告描述了回肠和胰腺NET以及NET肝转移瘤的超声形态学表现。
临床/方法学问题：小肠、胰腺NET及神经内分泌肝转移瘤的超声评估。
增强计算机断层扫描（CT）或磁共振成像（MRI）、未增强超声检查。
超声造影（CEUS）。
CEUS在NET检测及不明病变的鉴别诊断中辅助未增强超声检查，对肝转移瘤更敏感（根据文献，敏感性分别为99%和68%）。实用建议：CEUS可对NET进行初步评估并区分良性与恶性病变。然而，CEUS不能替代CT或MRI等更精细的成像方式进行全面的分期检查。
