Sheng RuoFan, Xie YanHong, Zeng MengSu, Ji Yuan, Rao ShengXiang, Chen CaiZhong
Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China.
Shanghai Institute of Medical Imaging, Shanghai, China.
Radiol Med. 2015 Nov;120(11):1012-20. doi: 10.1007/s11547-015-0544-y. Epub 2015 Apr 24.
To investigate MR characteristics in differentiating primary hepatic neuroendocrine neoplasm (PHNEN) from metastatic hepatic neuroendocrine neoplasm (MHNEN).
Thirty-nine patients with histopathologically proven liver neuroendocrine neoplasm were retrospectively analyzed. The morphological and MR signal features on T1, T2-weighted, dynamic-enhanced, and diffusion-weighted imaging were evaluated and compared between the PHNEN group (n = 12) and the MHNEN group (n = 27).
The tumor size (P = 0.0084), number (P = 0.017), distribution (P = 0.000), contour (P = 0.041), the presence of capsule-like enhancement (P = 0.034), tumor homogeneity (P = 0.018) and the apparent diffusion coefficient (ADC) values (P = 0.024) were different between PHNENs and MHNENs. Large, solitary or massive-growing nodules with lobulated or irregular contour, capsule-like enhancement, heterogeneous signals or lower ADC values supported the diagnosis of PHNEN compared with MHNEN. ROC analysis demonstrated an area under the curve of 0.746, when the optimal cutoff value of 1.049 × 10(-3) mm(2)/s was used, a sensitivity of 63.0 % (95 % CI, 44.2-79.4 %), a specitivity of 80.0 % (95 % CI, 50.1-96.4 %), a positive predictive value of 89.5 % (95 % CI, 70.9-98.2 %), and a negative predictive value of 44.4 % (95 % CI, 23.4-67.0 %) can be achieved.
MRI may provide valuable information for the diagnosis and differential diagnosis of PHNENs and MHNENs.
探讨磁共振成像（MR）特征在鉴别原发性肝脏神经内分泌肿瘤（PHNEN）与转移性肝脏神经内分泌肿瘤（MHNEN）中的应用。
回顾性分析39例经组织病理学证实的肝脏神经内分泌肿瘤患者。对PHNEN组（n = 12）和MHNEN组（n = 27）的T1加权、T2加权、动态增强及扩散加权成像的形态学和MR信号特征进行评估和比较。
PHNEN与MHNEN在肿瘤大小（P = 0.0084）、数量（P = 0.017）、分布（P = 0.000）、轮廓（P = 0.041）、包膜样强化的存在（P = 0.034）、肿瘤均匀性（P = 0.018）及表观扩散系数（ADC）值（P = 0.024）方面存在差异。与MHNEN相比，较大、孤立或呈块状生长的结节，具有分叶状或不规则轮廓、包膜样强化、信号不均匀或ADC值较低支持PHNEN的诊断。ROC分析显示曲线下面积为0.746，当使用最佳截断值1.049×10⁻³mm²/s时，灵敏度为63.0%（95%CI，44.2 - 79.4%），特异度为80.0%（95%CI，50.1 - 96.4%），阳性预测值为89.5%（95%CI，70.9 - 98.2%），阴性预测值为44.4%（95%CI，23.4 - 67.0%）。
MRI可为PHNEN和MHNEN的诊断及鉴别诊断提供有价值的信息。
