宫颈大细胞神经内分泌癌超声及MRI表现的初步探讨

Long Tan, Shi-Ji Wu, Yanzhe Qiu, Yue Jie, Shenyan Zhang, Shanglan Zhou, B. Luo, N. Di
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摘要

目的:分析8例宫颈大细胞神经内分泌癌的超声和MRI表现,以提高超声、放射科医师和临床医生对该病的认识。方法:回顾性分析2018年2月至2021年4月中山大学中山纪念医院经病理证实的8例宫颈大细胞神经内分泌癌患者的临床资料,并结合临床、常规超声、增强超声及MRI特征进行分析。结果:8例宫颈大细胞神经内分泌癌的常规超声检查有两个特点:(1)肌肉层低回声区不规则,有微高回声嵌条,病灶轮廓不清晰;(2)病灶内血流分布微丰富。超声造影呈“快进快出”模式;沉降后观察到“栅栏状”变化,增强幅度明显大于二维超声范围。MRI上T1WI呈低信号或等信号;T2WI呈高信号;DWI表现为高信号低ADC值;大部分增强MRI表现为不均匀高强化。结论:常规超声、增强超声和MRI是互补的检查方法,可为宫颈大细胞神经内分泌癌的诊断提供额外的影像学信息。
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Preliminary Investigation into Ultrasound and MRI Presentation of Large-Cell Neuroendocrine Carcinomas of the Uterine Cervix
Objective: The aim of this study was to analyze the ultrasound and MRI features of eight patients with cervical large-cell neuroendocrine carcinoma to improve awareness of this disease among sonographers, radiologists, and clinicians.Methods: Clinical data for eight patients with cervical large-cell neuroendocrine carcinoma confirmed by pathology at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between February 2018 and April 2021 were retrospectively analyzed according to clinical, conventional ultrasound, contrast-enhanced ultrasound, and MRI characteristics.Results: Conventional ultrasound examination of the cervical large-cell neuroendocrine carcinoma lesions in the eight patients revealed two features: (1) irregular hypoechoic areas in the muscular layer, with slightly hyperechoic inlay streaks, and poorly delineated lesions, and (2) slightly abundant blood flow distribution in the lesions. The contrast-enhanced ultrasound showed a “fast-in and fast-out” mode; after subsidence, a “fence-like” change was observed, and the enhancement range was significantly greater than the range of two-dimensional ultrasound. In MRI, T1WI showed a low signal or isosignal; T2WI showed a high signal; DWI showed a high signal and low ADC value; and most of the enhanced MRI showed inhomogeneous hyperenhancement.Conclusion: Conventional ultrasound, contrast-enhanced ultrasound and MRI are complementary methods that provide additional imaging information for the diagnosis of cervical large-cell neuroendocrine carcinoma.
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