Bicci Eleonora, Cozzi Diletta, Ferrari Riccardo, Grazzini Giulia, Pradella Silvia, Miele Vittorio
Department of Emergency Radiology, Careggi University Hospital, Florence, Italy.
Department of Emergency Radiology, San Camillo Forlanini Hospital, Rome, Italy.
Gland Surg. 2020 Dec;9(6):2215-2224. doi: 10.21037/gs-20-537.
Pancreatic neuroendocrine tumours (pNETs) are rare and heterogeneous group of neoplasms presenting with a wide variety of symptoms and biological behaviour, from indolent to aggressive ones. pNETs are stratified into functional or non-functional, because of their ability to produce metabolically active hormones. pNETs can be an isolate phenomenon or a part of a hereditary syndrome like von Hippel-Lindau syndrome or neurofibromatosis-1. The incidence has increased in the last years, also because of the improvement of cross-sectional imaging. Computed tomography (CT), magnetic resonance imaging (MRI) and functional imaging are the mainstay imaging modalities used for tumour detection and disease extension assessment, due to easy availability and better contrast/spatial resolution. Radiological imaging plays a fundamental role in detection, characterization and surveillance of pNETs and is involved in almost every stage of patients' management. Moreover, with specific indications and techniques, interventional radiology can also play a role in therapeutic management. Surgery is the treatment of choice, consisting of either partial pancreatectomy or enucleation of the primary tumour. This article reviews the radiologic features of different pNETs as well as imaging mimics, in order to help radiologists to avoid potential pitfalls, to reach the correct diagnosis and to support the multidisciplinary team in establishing the right treatment.
胰腺神经内分泌肿瘤(pNETs)是一组罕见且异质性的肿瘤,表现出各种各样的症状和生物学行为,从惰性到侵袭性不等。由于其产生具有代谢活性激素的能力,pNETs被分为功能性或非功能性。pNETs可以是孤立现象,也可以是遗传性综合征(如冯·希佩尔-林道综合征或神经纤维瘤病1型)的一部分。近年来,其发病率有所上升,这也归因于横断面成像技术的进步。计算机断层扫描(CT)、磁共振成像(MRI)和功能成像由于易于获得且具有更好的对比度/空间分辨率,是用于肿瘤检测和疾病扩展评估的主要成像方式。放射学成像在pNETs的检测、特征描述和监测中起着重要作用,几乎涉及患者管理的每个阶段。此外,在特定的适应证和技术条件下,介入放射学在治疗管理中也能发挥作用。手术是首选治疗方法,包括部分胰腺切除术或原发性肿瘤摘除术。本文综述了不同pNETs的放射学特征以及影像模拟,以帮助放射科医生避免潜在的陷阱,做出正确诊断,并支持多学科团队制定正确的治疗方案。