Yun Bo La, Kim Se Hyung, Kim Soo Jin, Lee Min Woo, Lee Jae Young, Han Joon Koo, Choi Byung Ihn
Department of Radiology, Seoul National University Hospital, Seoul, Korea.
J Comput Assist Tomogr. 2010 Nov-Dec;34(6):899-906. doi: 10.1097/RCT.0b013e3181ec0829.
To retrospectively assess the added value of multiplanar reformations (MPR) to axial multi-detector row computed tomographic (MDCT) images in differentiating macrocystic pancreas neoplasms.
Approval from the institutional review board was obtained. Two radiologists retrospectively reviewed axial CT images of 48 pathologically proven pancreas macrocystic neoplasms with and without MPRs. They were asked to determine the presence of pancreatic duct (PD) communication with the lesions and whether the lesion is an intraductal papillary mucinous neoplasm (IPMN) or not on a 5-point confidence scale and to record the specific diagnoses and their confidence. Radiologists' performances for determining PD communication and lesion differentiation using axial CT with and without MPRs were evaluated using receiver operating characteristic analysis. To determine the accuracy of the specific diagnoses, Fisher exact and Mann-Whitney U tests were used. Interobserver agreement was also analyzed.
With the addition of MPRs, receiver operating characteristic analysis revealed a tendency toward improved determination of PD communication and better differentiation between IPMN and non-IPMN. However, a significant difference was found only in reviewer 2 for the determination of PD communication (P = 0.009). Diagnostic accuracy of specific diagnoses was also improved; however, the differences were not significant. Specific diagnoses were more confidently made with the addition of MPRs than with axial images alone, and a significant difference was seen for reviewer 2 (P < 0.001). Furthermore, substantial interobserver agreement was achieved with the addition of MPRs, whereas fair or substantial agreement was noted with axial images alone.
The addition of MPRs to axial CT images may improve diagnostic performance and decrease interobserver variability of MDCT for the determination of PD communication with macrocystic pancreatic neoplasms and differentiation between IPMN and non-IPMN.
回顾性评估多平面重建（MPR）对轴位多排螺旋计算机断层扫描（MDCT）图像在鉴别大囊型胰腺肿瘤中的附加价值。
获得机构审查委员会的批准。两名放射科医生回顾性地审查了48例经病理证实的胰腺大囊型肿瘤的轴位CT图像，有无MPR。要求他们在5分置信度量表上确定胰管（PD）与病变是否相通，以及病变是否为导管内乳头状黏液性肿瘤（IPMN），并记录具体诊断及其置信度。使用受试者操作特征分析评估放射科医生使用有无MPR的轴位CT确定PD相通和病变鉴别的表现。为确定具体诊断的准确性，使用了Fisher精确检验和Mann-Whitney U检验。还分析了观察者间的一致性。
添加MPR后，受试者操作特征分析显示在确定PD相通以及IPMN与非IPMN之间的鉴别上有改善的趋势。然而，仅在审阅者2确定PD相通方面发现有显著差异（P = 0.009）。具体诊断的诊断准确性也有所提高；然而，差异不显著。添加MPR后比仅使用轴位图像能更有信心地做出具体诊断，审阅者2有显著差异（P < 0.001）。此外，添加MPR后观察者间达成了高度一致，而仅使用轴位图像时观察者间一致性为中等或高度一致。
在轴位CT图像上添加MPR可能会提高MDCT在确定PD与大囊型胰腺肿瘤是否相通以及IPMN与非IPMN之间鉴别的诊断性能，并减少观察者间的变异性。
Zotero 插件