Gusmini S, Nicoletti R, Martinenghi C, Caborni C, Balzano G, Zerbi A, Rocchetti S I, Arcidiacono P G, Albarello L, De Cobelli F, Di Carlo V, Del Maschio A
Department of Radiology, Vita-Salute University, San Raffaele Hospital, Via Olgettina 60, I-20132, Milan, Italy.
Radiol Med. 2007 Oct;112(7):999-1012. doi: 10.1007/s11547-007-0201-1. Epub 2007 Oct 21.
The aim of this study was to assess whether the pancreatic phase may replace the arterial phase in the evaluation of endocrine pancreatic tumours.
Twenty-nine endocrine pancreatic lesions with definitive morphological and immunohistochemical characterisation after surgical treatment (n=24) or fine-needle-aspiration cytology under endoscopic ultrasonography guidance (n=5) were retrospectively evaluated. All lesions were studied with triple-phase 16-row multidetector computed tomography (MDCT). Images obtained during each phase were separately interpreted by two senior radiologists experienced in pancreatic pathology and who were blinded to surgical results. Endocrine tumour and normal pancreas attenuation and the mean absolute tumour-to-gland attenuation difference were measured in each phase, and data were analysed with Student's t test. Visualisation of arterial vascular abnormalities and hypervascular liver metastases in the arterial and pancreatic phases and the diagnostic contribution of the two phases were compared.
For both radiologists, the mean absolute tumour-to-gland attenuation difference was significantly higher (p<0.05) in the pancreatic phase (40+/-53 HU and 34+/-56 HU) than in the arterial phase (31+/-38 HU and 26+/-43 HU). There were no differences in the detection of arterial vascular abnormalities or hypervascular liver metastases in the two phases. The diagnostic contribution was higher in the pancreatic phase.
In our experience, the pancreatic phase can replace the arterial phase in the evaluation of pancreatic endocrine tumours.
本研究旨在评估在胰腺内分泌肿瘤评估中，胰腺期是否可取代动脉期。
回顾性评估29例胰腺内分泌病变，这些病变经手术治疗（n = 24）或在内镜超声引导下细针穿刺细胞学检查（n = 5）后具有明确的形态学和免疫组化特征。所有病变均采用16排多层螺旋计算机断层扫描（MDCT）进行三相检查。由两位在胰腺病理学方面经验丰富且对手术结果不知情的资深放射科医生分别解读各期获得的图像。在各期测量内分泌肿瘤和正常胰腺的衰减以及肿瘤与腺体的平均绝对衰减差值，并采用Student's t检验分析数据。比较动脉期和胰腺期动脉血管异常和富血供肝转移灶的显示情况以及两期的诊断价值。
两位放射科医生均发现，胰腺期肿瘤与腺体的平均绝对衰减差值（40±53 HU和34±56 HU）显著高于动脉期（31±38 HU和26±43 HU）（p<0.05）。两期在动脉血管异常或富血供肝转移灶的检测方面无差异。胰腺期的诊断价值更高。
根据我们的经验，在胰腺内分泌肿瘤评估中，胰腺期可取代动脉期。
