Vinci R, Stabile Ianora A A, Magliocca M, Scialpi M, Rotondo A, Angelelli G
Istituto di Radiologia dell'Università, Bari.
Radiol Med. 1998 Sep;96(3):209-13.
We studied the CT patterns of abdominal carcinoid tumors.
Eight patients with carcinoid tumors were examined with CT. The tumors were in the ileum (2 patients), duodenum (1), colon (1), and mesentery (4). Pathologic confirmation was obtained at surgery in all patients. The symptoms were the carcinoid syndrome in 2 patients, abdominal pain in 4, jaundice in 1 patient and a right lower quadrant mass in 1. All patients were examined with(out) i.v. contrast agent administration; 6 patients received oral contrast material and 2 were submitted to water enema, to enhance visualization of the distal ileum and colon.
CT identified the tumor in all patients but correctly defined its site in 7 cases only. CT showed a small mass in the distal common bile duct in 1 case, which postoperative histology diagnosed as a malignant carcinoid tumor of the duodenum. The CT findings of carcinoid tumors were a rounded mesenteric mass displacing bowel loops in 4 cases, an infiltrating colonic tumor in 1 case, an apparently intracholedochal mass in 1, a large necrotic mesenteric mass in 1 case. CT showed lymph node involvement in 2 cases, but no liver metastases were found. A carcinoid tumor was diagnosed in 4 patients based on the typical CT finding of a mesenteric mass with radiating soft-tissue density bands resulting in a stellate pattern. No preoperative diagnosis was possible in some other cases because the CT patterns were aspecific and mimicked those of other lesions, namely of tumor of the distal common bile duct, adenocarcinoma of the right colon, submucosal tumor of the distal ileum, large necrotic mesenteric mass.
CT is a useful tool in the detection of carcinoid tumors. The correct diagnosis can be made based on the characteristic CT finding of a rounded mesenteric mass. In our experience, however, carcinoid tumors may present with other CT patterns mimicking those of other tumors.
我们研究了腹部类癌肿瘤的CT表现。
对8例类癌肿瘤患者进行了CT检查。肿瘤位于回肠（2例）、十二指肠（1例）、结肠（1例）和肠系膜（4例）。所有患者均在手术中获得病理证实。症状包括类癌综合征2例、腹痛4例、黄疸1例和右下腹肿块1例。所有患者均在静脉注射（未注射）造影剂的情况下进行检查；6例患者接受了口服造影剂，2例接受了水灌肠，以增强回肠末端和结肠的可视化。
CT在所有患者中均发现了肿瘤，但仅在7例中正确确定了其位置。CT显示1例胆总管远端有一个小肿块，术后组织学诊断为十二指肠恶性类癌肿瘤。类癌肿瘤的CT表现为：4例为圆形肠系膜肿块，推移肠袢；1例为浸润性结肠肿瘤；1例为明显的胆总管内肿块；1例为大的坏死性肠系膜肿块。CT显示2例有淋巴结受累，但未发现肝转移。4例患者根据肠系膜肿块典型的CT表现及放射状软组织密度带形成的星状图案诊断为类癌肿瘤。在其他一些病例中，术前无法做出诊断，因为CT表现不具特异性，与其他病变相似，即胆总管远端肿瘤、右半结肠癌、回肠末端黏膜下肿瘤、大的坏死性肠系膜肿块。
CT是检测类癌肿瘤的有用工具。根据圆形肠系膜肿块的特征性CT表现可做出正确诊断。然而，根据我们的经验，类癌肿瘤可能表现出其他与其他肿瘤相似的CT表现。
