Department of Medical Imaging, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland).
Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland).
Med Sci Monit. 2020 Apr 1;26:e920952. doi: 10.12659/MSM.920952.
BACKGROUND In most cases, biliary tract intraductal papillary mucinous neoplasm (BT-IPMN) is depicted by pathological features rather than on imaging modalities, but fine-needle aspiration cytology cannot provide complete information on tumor(s). Computed tomography (CT) has the advantage of high spatial resolution and multiplanar capabilities, while magnetic resonance imaging (MRI) has greater contrast resolution than CT. The purpose of this study was to compare the diagnostic performance of CT vs. MRI for the diagnosis of BT-IPMN using surgical pathology as the reference standard. MATERIAL AND METHODS Data from CT, MRI, and surgical pathology of 210 patients with complaints of abdominal discomfort, vomiting, and/or jaundice for at least 6 months were included in the analysis. Intra-observer agreements for diagnosis of neoplasm was evaluated by kappa statistics. RESULTS CT and MRI respectively detected 171 and 33 patients with BT-IPMN, 6 and 176 with biliary intraductal tubulopapillary neoplasms (BT-ITPN), and 28 and 6 with inconclusive results. Surgical pathology reported 179 patients with BT-IPMN and 25 patients with BT-ITPN. CT and MRI both had the same accuracy (97.14%) for BT-IPMN. The sensitivities for diagnosis of BT-IPMN were 87.75%, 83.81%, and 81.43% for the surgical pathology, MRI, and CT, respectively. Intra-observer agreements for diagnosis of neoplasm were substantial (k=0.79), perfect (k=0.81), and perfect (k=0.85) for CT, MRI, and surgical pathology, respectively. CONCLUSIONS MRI appears to be a more accurate and reliable method than CT for depicting BT-IPMN.
在大多数情况下，胆管内乳头状黏液性肿瘤（BT-IPMN）是通过病理特征而非影像学表现来描述的，但细针穿刺细胞学检查不能提供肿瘤的完整信息。计算机断层扫描（CT）具有高空间分辨率和多平面能力的优势，而磁共振成像（MRI）则比 CT 具有更高的对比分辨率。本研究旨在比较 CT 与 MRI 对以手术病理为参考标准的 BT-IPMN 的诊断性能。
分析了 210 例因腹部不适、呕吐和/或黄疸至少 6 个月就诊的患者的 CT、MRI 和手术病理资料。通过kappa 统计评估诊断肿瘤的观察者内一致性。
CT 和 MRI 分别检出 171 例和 33 例 BT-IPMN、6 例和 176 例胆管内管状乳头状肿瘤（BT-ITPN）、28 例和 6 例结果不确定。手术病理报告 179 例 BT-IPMN 和 25 例 BT-ITPN。CT 和 MRI 对 BT-IPMN 的准确率相同（97.14%）。BT-IPMN 的诊断敏感性分别为手术病理、MRI 和 CT 的 87.75%、83.81%和 81.43%。诊断肿瘤的观察者内一致性分别为 CT 的显著（k=0.79）、完美（k=0.81）和完美（k=0.85），MRI 的完美（k=0.81）和完美（k=0.85），以及手术病理的完美（k=0.85）。
与 CT 相比，MRI 似乎是一种更准确、更可靠的方法，用于描绘 BT-IPMN。
