Park Hye Sun, Kim So Yeon, Hong Seung-Mo, Park Seong Ho, Lee Seung Soo, Byun Jae Ho, Kim Jin Hee, Kim Hyoung Jung, Lee Moon-Gyu
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
Eur Radiol. 2016 May;26(5):1348-58. doi: 10.1007/s00330-015-3961-3. Epub 2015 Sep 2.
To describe imaging findings of arterial hypervascular solid-appearing serous cystic neoplasms (SCNs) of the pancreas on CT and MR and determine imaging features differentiating them from neuroendocrine tumours (NETs).
We retrospectively identified 15 arterial hypervascular solid-appearing SCNs and randomly chose 30 size-matched pancreatic NETs. On CT, two radiologists in consensus assessed the size, morphology, and CT attenuation. On MR, predominant signal intensity and the amount of the cystic component on T2-weighted images and ADC maps were evaluated and compared using Fisher's exact and Student's t-test.
The mean SCN size was 2.6 cm (range, 0.8-8.3). The CT findings were similar between the two tumours: location, shape, margin, and enhancement pattern. SCNs were significantly more hypodense on non-enhanced CT images than NETs (P = .03). They differed significantly on MR: bright signal intensity (P = .01) and more than a 10% cystic component on T2-weighted images (P = .01) were more common in SCNs than in NETs. All SCNs showed a non-restrictive pattern on the ADC map, while NETs showed diffusion restriction (P < .01).
Arterial hypervascular solid-appearing SCNs and NETs share similar imaging features. Non-enhanced CT and MR images with T2-weighted images and ADC maps can facilitate the differentiation.
• Frequency of hypervascular solid-appearing SCNs was 7.3% among surgically confirmed SCNs. • Hypervascular solid-appearing SCN of the pancreas can mimic pancreatic NETs. • Unenhanced CT and MR features help to differentiate the two tumours.
描述胰腺实性表现的富血供浆液性囊性肿瘤（SCNs）在CT和MR上的影像表现，并确定将其与神经内分泌肿瘤（NETs）区分开来的影像特征。
我们回顾性地识别出15例实性表现的富血供SCNs，并随机选取30例大小匹配的胰腺NETs。在CT上，两名放射科医生共同评估大小、形态和CT衰减。在MR上，使用Fisher精确检验和Student t检验对T2加权图像和ADC图上的主要信号强度和囊性成分的量进行评估和比较。
SCNs的平均大小为2.6 cm（范围0.8 - 8.3）。两种肿瘤的CT表现相似：位置、形状、边缘和强化方式。SCNs在非增强CT图像上比NETs明显密度更低（P = 0.03）。它们在MR上有显著差异：SCNs在T2加权图像上比NETs更常见高信号强度（P = 0.01）和超过10%的囊性成分（P = 0.01）。所有SCNs在ADC图上表现为非限制性模式，而NETs表现为弥散受限（P < 0.01）。
实性表现的富血供SCNs和NETs具有相似的影像特征。非增强CT以及带有T2加权图像和ADC图的MR图像有助于鉴别。
• 在手术确诊的SCNs中，实性表现的富血供SCNs的发生率为7.3%。• 胰腺实性表现的富血供SCN可模仿胰腺NETs。• 非增强CT和MR特征有助于区分这两种肿瘤。
