| Part Ⅰ CT imaging findings of endocrine tumor of the stomach according to 2010 WHO classification[Purpose]:To describe the computed tomographic (CT) findings of gastric neuroendocrine neoplasm (G-NEN). To determine whether CT parameters differ between tumor grades.[Materials and methods]:Both plain and enhanced spiral CT findings in 33 cases with gastric neuroendocrine neoplasm were retrospectively analyzed.33 patients with histologically or pathologically documented. G-NEN were included in this study. All of the tumors were graded as G1 to G3 according to the WHO classification in 2010. The lesions’number, location, shape, size, density, enhancement patterns and other changes on contrast-enhanced CT images were observed. A Kruskal Wallis test were performed to compare differences of tumor diameters and the enhancement indices. The change trend of enhancement indices varying with pathology grading were described. Fisher exact test was used to find differences of CT imaging characters between NET(G1、G2) and NEC (G3)[Results]:Of the 33 G-NEN patients,32 patients had single G-NEN and multiple NEN was detected in 1 cases. All of them had no endocrine symptoms.Gl tumors were found in 13 patients, G2 in 2 patients, G3 in 18 patients, and mixed adenoneuroendocrine carcinoma in 1 patient. Marked enhancement were observed on CT scan. Tumor located at the gastric fundus and cardia part in 9 cases(8/9,NEC), greater curvature of stomach body in 9 cases(6/9,NET), the lesser curvature in 13 cases(9/13,NEC), and antrum in 3 cases(2/3,NET). The tumor size was less than 3cm in diameter in 13 cases (13/13, NET), and larger than 3cm in 21 cases (18/21, NEC). Ulceration was observed in 17 cases (15/17, NEC).15 tumors showed intra-luminal growth (12/15, NET) and 19 cases involved both intra and extra-luminal (19/19, NEC). Metastases were observed in 14 cases (14/14, NEC). All of the indices mentioned aboved were of significant difference (P<0.005) and the other indices showed no significant difference.[Conclusion]:G-NEN are commonly hypervascular. CT imaging features correlates to the pathological grade. Thus, CT imaging findings may be beneficial in the evaluation of the tumor grade prior to resection or biopsy.Part Ⅱ Imaging findings of endocrine tumor of the rectum[Purpose]:In order to improve the preoperative diagnostic accuracy, imaging findings of rectal neuroendocrine neoplasm(NEN) were described and analyzed.[Materials and methods]:Both plain and enhanced spiral imaging findings in 37 cases with rectal neuroendocrine neoplasm were retrospectively analyzed, with histologically or pathologically documented. All of the tumors were graded as G1 to G3 according to the WHO classification in 2010. The lesions’ number, location, shape, size, density, enhancement patterns and other changes on contrast-enhanced images were observed.[Results]:Of the 37 rectal NEN patients,33 patients had single rectal NEN and multiple NEN was detected in 4 cases. All of them had no endocrine symptoms.Gl tumors were found in 32 patients, G2 in 1 patients, G3 in 4 patients. Marked enhancement was observed on CT scan. The lesions in NET (Neuroendocrine tumor, G1 and G2) appeared as submucol hemispherical polypoid bulge (30/33), the tumor size was less than 2.0 cm in diameter in 33 cases(33/33, a mean value of 6.4cm), regular in shape and well defined(33/33), marked enhancement(33/33).Lymphadenopathy at peritoneal cavity was founded in 1 case(1/33), metastatic hepatic neuroendocrine carcinoma was no founded(0/33).The lesions in NEC(Neuroendocrine carcinoma,G3) were often larger than 2.0cm in diameter(a mean value of 6.4cm), mural mass with asymmetric or concentric bowel wall thickening in 4 cases (NEC,4/4), irregular in shape and ill-defined (4/4), periplasmic space was invaded in 4 cases(NEC,4/4), Lymph nodes metastases were present at 3 cases(3/4) and hepatic metastases were present at 1 cases(1/4).[Conclusion]:Rectal NEN are commonly hypervascular. Imaging features correlates to the pathological grade. |
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