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胰腺实性型浆液性囊腺瘤与神经内分泌肿瘤的鉴别诊断:腹部 MRI 联合弥散加权成像与 MDCT 的对比价值。

Differentiation of solid-type serous cystic neoplasm from neuroendocrine tumour in the pancreas: value of abdominal MRI with diffusion-weighted imaging in comparison with MDCT.

机构信息

Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, Republic of Korea.

Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, Republic of Korea.

出版信息

Clin Radiol. 2015 Feb;70(2):153-60. doi: 10.1016/j.crad.2014.10.010. Epub 2014 Nov 22.

Abstract

AIM

To evaluate the value of abdominal MRI with diffusion-weighted (DW) imaging for differentiation of solid-type serous cystic neoplasm (SCN) from neuroendocrine tumour (NET) in the pancreas compared with that of CT.

MATERIALS AND METHODS

Ten solid-type SCNs and 15 NETs were included in the study. Qualitative and quantitative analyses were performed, and two observers independently reviewed CT and MRI images for diagnosis of solid-type SCNs. Fisher's exact test and Mann-Whitney U-test, diagnostic performance [receiver operating characteristic (ROC) curve analysis] were evaluated.

RESULTS

SCNs showed more frequently hypo-attenuation on unenhanced CT images and marked hyperintensity on T2-weighted images compared with NETs (p < 0.01). The density of the tumour on unenhanced CT images and the apparent diffusion coefficient (ADC) value of the tumour were significantly different between SCNs (mean 18.5 HU; mean 2.45 × 10(-3) mm(2)/s) and NETs (mean 39.2 HU; mean 1.51 × 10(-3) mm(2)/s; p < 0.001). In the differentiation of SCNs from NETs, diagnostic performance of MRI with DW images was significantly higher than that of CT imaging (p < 0.01).

CONCLUSION

Abdominal DW-MRI shows a higher diagnostic accuracy than abdominal CT imaging in the differentiation of solid-type SCNs from NETs.

摘要

目的

评估腹部 MRI 扩散加权成像(DW)在鉴别胰腺实性浆液性囊腺瘤(SCN)与神经内分泌肿瘤(NET)方面的价值,并与 CT 进行比较。

材料与方法

纳入 10 例实性 SCN 和 15 例 NET。对其进行定性和定量分析,由 2 名观察者独立对 CT 和 MRI 图像进行诊断。采用 Fisher 确切检验和 Mann-Whitney U 检验进行评估,诊断性能(ROC 曲线分析)。

结果

与 NET 相比,SCN 在平扫 CT 图像上表现为更常见的低信号强度,在 T2 加权图像上表现为明显的高信号强度(p < 0.01)。肿瘤在平扫 CT 图像上的密度和肿瘤的表观扩散系数(ADC)值在 SCN(平均 18.5 HU;平均 2.45×10(-3) mm(2)/s)和 NET (平均 39.2 HU;平均 1.51×10(-3) mm(2)/s;p < 0.001)之间有显著差异。在 SCN 与 NET 的鉴别诊断中,DW-MRI 的诊断性能明显高于 CT 成像(p < 0.01)。

结论

腹部 DW-MRI 在鉴别胰腺实性浆液性囊腺瘤与神经内分泌肿瘤方面的诊断准确性高于腹部 CT 成像。

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