Department of Radiology and the Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
Department of Radiology, Ansan Hospital, Korea University College of Medicine, 516, Gojan 1-dong, Danwon-gu, Ansan-Si, 15355, Gyeonggi, South Korea.
Abdom Radiol (NY). 2017 Dec;42(12):2835-2842. doi: 10.1007/s00261-017-1212-6.
To compare CT findings and survival between patients with pancreatic neuroendocrine tumors (pNETs) with and without fibrosis.
Forty-five pNET patients with intratumoral fibrosis (group A) were matched for age, gender, and tumor size and grade with 45 pNET patients without (group B), and CT images were retrospectively reviewed. Hounsfield units (HUs) of tumors in unenhanced, arterial and portal phases, HU ratio (tumor to normal parenchyma) in each phase, enhancement patterns, visible enhancement pattern changes, and survival were compared.
Group A showed progressive enhancement patterns, while group B showed early enhancement and wash-out patterns (p < 0.05). HUs of tumors and HU ratio in the unenhanced phase were significantly higher in group A than group B (p ≤ 0.024), whereas those in the arterial phase were significantly lower in group A than group B (p ≤ 0.003). Peripheral to full or peripheral to peripheral enhancement change was more frequent in group A, while full to full enhancement change was more frequent in group B (p < 0.05). Group A showed significantly lower overall survival than group B (p = 0.029).
pNETs with fibrosis showed a progressive enhancement pattern and worse overall survival than pNETs without, which showed an early enhancement and wash-out pattern.
比较伴有和不伴有纤维化的胰腺神经内分泌肿瘤（pNET）患者的 CT 表现和生存情况。
将 45 例伴有肿瘤内纤维化的 pNET 患者（A 组）与 45 例无纤维化的 pNET 患者（B 组）按年龄、性别和肿瘤大小及分级进行匹配，并回顾性分析 CT 图像。比较两组患者肿瘤的平扫、动脉期和门静脉期的 CT 值（HU）、各期的肿瘤与正常实质的 HU 比值、强化模式、可见强化模式的变化以及生存情况。
A 组表现为渐进性强化模式，而 B 组表现为早期强化和廓清模式（p<0.05）。A 组肿瘤的平扫 HU 值和 HU 比值均显著高于 B 组（p≤0.024），而动脉期 HU 值显著低于 B 组（p≤0.003）。A 组更常见外周至全周或外周至部分强化改变，而 B 组更常见全周至全周强化改变（p<0.05）。A 组的总体生存率显著低于 B 组（p=0.029）。
与无纤维化的 pNET 相比，伴有纤维化的 pNET 表现为渐进性强化模式和更差的总体生存率，而无纤维化的 pNET 表现为早期强化和廓清模式。
