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目的 探讨部分或完全低强化型胰腺神经内分泌肿瘤(PNENs)多层螺旋CT(MSCT)的影像学特征.方法 回顾性分析44例PNENs患者的临床及术前MSCT资料,主要记录肿瘤直径、部位、边界、密度、内部结构、是否合并胰胆管扩张、有无远处器官转移等信息,并按胰腺期强化特征将其分为完全强化型及部分或完全低强化型进行比较分析.结果 44例PNENs患者中共发现肿瘤56枚,部分或完全低强化型组31枚,完全强化型组25枚,前者肿瘤直径(3.3±2.2)cm,大于后者(1.4±0.9)cm,且形态不规则者居多,肿瘤内可出现囊性成分,两组间的差异具有统计学意义(P<0.05),而患者性别、肿瘤是否有功能、肿瘤的部位、病灶边缘是否清晰、内部是否出现钙化、胰胆管是否扩张、是否出现转移等两组比较差异无统计学意义.增强后完全强化型病灶的强化峰值多出现于动脉期(76.0%,19/25),而部分或完全低强化型病灶的强化峰值多出现于胰腺期(71.0%,22/31),并且在动脉期病灶内可出现增强迂曲的微血管影,差异具有统计学意义(P<0.05).完全强化型病灶中G1级21例,G2级4例,无G3级病例;部分或完全低强化型病灶G1级18例,G2级5例,G3级8例,两组之间差异有统计学意义(P<0.05).结论 部分或完全低强化型PNENs与完全强化型PNENs相比,体积较大,形态不规则,内部可含囊性成分,增强后动脉期易出现迂曲的微血管影,强化峰值出现略晚,病理学分级较高.“,”Objective To observe MSCT features of partially or completely low enhancement of pancreas neuroendocrine tumors (PNENs).Methods The clinical data and MSCT features before pancreatectomy in 44 patients with confirmed PNENs were retrospectively reviewed.The MSCT findings were evaluated including tumor size, location, margin, density, intratumoral structure, bile duct and pancreatic ductal dilation and distant metastasis.Tumors were classified into complete enhancement type, partially or completely low enhancement type for further comparative analysis based on MSCT enhancement during pancreatic stage.Results A total of 56 PNENs in 44 patients were found, and there were 31 partially or completely low enhanced PNENs and 25 completely enhanced PNENs.The former were larger than the latter [mean tumor size, (3.3±2.2)cm vs (1.4±0.9) cm], and irregular shape and cystic components within tumors were more often observed (all P<0.05).There were no significant differences between the two types of PNENs in terms of gender, the presence of functional tumor, tumor location, clear tumor margin, intratumoral calcification, bile and pancreatic duct dilation and metastasis.76.0%(19/25) of completely enhanced PNENs reached peak enhancement in arterial phase, and 71.0%(22/31) of low enhancement PNENs reached peak in pancreatic phase.Enhanced intratumoral blood vessels in the arterial phase were more frequent in low enhancement PNENs, and the difference was statistically significant (P<0.05).There were significant differences on pathological grade between the two types of PNENs (G1=21,G2=4,G3=0 vs G1=18,G2=5, G3=8), and the difference was statistically significant (P<0.05).Conclusions Compared with complete enhancement PNENs, partially or completely low enhancement PNENs had bigger size, irregular shape, and cystic component.Intratumoral blood vessels in the arterial phase were observed, peak enhancement arrived later and the pathological grade was higher.