超顺磁性氧化铁增强弥散加权磁共振成像在胰内副脾诊断中的应用。

Superparamagnetic iron-oxide-enhanced diffusion-weighted magnetic resonance imaging for the diagnosis of intrapancreatic accessory spleen.

机构信息

Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

出版信息

Abdom Radiol (NY). 2019 Oct;44(10):3325-3335. doi: 10.1007/s00261-019-02189-8.

DOI:10.1007/s00261-019-02189-8

PMID:31420705

Abstract

PURPOSE

To evaluate the diagnostic performance of superparamagnetic iron-oxide (SPIO)-enhanced diffusion-weighted image (DWI) for distinguishing an intrapancreatic accessory spleen from pancreatic tumors.

MATERIALS AND METHODS

Twenty-six cases of intrapancreatic accessory spleen and nine cases of pancreatic tail tumors [neuroendocrine tumor (n = 8) and pancreatic adenocarcinoma (n = 1)] were analyzed. Two blind reviewers retrospectively reviewed the SPIO-enhanced magnetic resonance imaging (MRI) scans. The lesion visibility grades were compared and the diagnostic performance of SPIO-enhanced DWI was compared to those of SPIO-enhanced T2WI and T2*WI with the use of a receiver operating characteristic (ROC) analysis.

RESULTS

The grade of lesion visibility was the highest on DWI [mean ± standard deviation (SD): 2.8 ± 0.3] followed by T2WI (2.3 ± 0.7, p < 0.001) and T2WI (2.1 ± 0.7, p < 0.0001). Reviewers 1 and 2 correctly characterized the presence or absence of SPIO uptake in 34 of 35 cases (97.1%) on DWI, 24 (68.6%) and 25 (71.4%) cases on T2WI, respectively, and 16 (45.7%) and 17 (48.6%) cases on T2WI. The area under the ROC curve (AUC) of DWI was 0.974 and 0.989 for reviewers 1 and 2, respectively. For Reviewer 1, the AUC of DWI was significantly higher than that of T2WI (0.756, p < 0.01), although it was not significantly different from that of T2WI (0.868, p = 0.0857). For Reviewer 2, the AUC of DWI was significantly higher than those of T2WI (0.846, p < 0.05) and T2WI (0.803, p < 0.01).

CONCLUSION

The diagnostic performance of SPIO-enhanced DWI was better than those of SPIO-enhanced T2*WI and T2WI for the diagnosis of intrapancreatic accessory spleen.

摘要

目的

评估超顺磁性氧化铁（SPIO）增强扩散加权成像（DWI）在鉴别胰内副脾与胰腺肿瘤方面的诊断性能。

材料与方法

分析 26 例胰内副脾和 9 例胰尾肿瘤[神经内分泌肿瘤（n=8）和胰腺腺癌（n=1）]病例。两名盲法阅片者回顾性分析 SPIO 增强磁共振成像（MRI）扫描。比较病变可见度等级，并使用受试者工作特征（ROC）分析比较 SPIO 增强 DWI 与 SPIO 增强 T2WI 和 T2*WI 的诊断性能。

结果

DWI 上病变可见度评分最高[平均值±标准差（SD）：2.8±0.3]，其次是 T2WI（2.3±0.7，p<0.001）和 T2WI（2.1±0.7，p<0.0001）。阅片者 1 和 2 在 DWI 上正确识别 35 例（97.1%）中 SPIO 摄取的存在或缺失，在 T2WI 上分别正确识别 24（68.6%）和 25（71.4%）例，在 T2WI 上分别正确识别 16（45.7%）和 17（48.6%）例。DWI 的 ROC 曲线下面积（AUC）分别为 0.974 和 0.989，对于阅片者 1 和 2。对于阅片者 1，DWI 的 AUC 明显高于 T2WI（0.756，p<0.01），尽管与 T2WI（0.868，p=0.0857）无显著差异。对于阅片者 2，DWI 的 AUC 明显高于 T2WI（0.846，p<0.05）和 T2WI（0.803，p<0.01）。