Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Room 143, Baltimore, MD, 21287, USA.
Abdom Radiol (NY). 2021 Apr;46(4):1629-1639. doi: 10.1007/s00261-020-02792-0. Epub 2020 Oct 9.
To evaluate the use of volumetric multiparametric MRI in differentiating pancreatic intraductal papillary mucinous neoplasms (IPMNs) from serous cystadenomas (SCAs) METHODS: Included patients (123 patients with pancreatic cystic neoplasms (PCNs) measuring ≥ 10 mm) were stratified into two groups based on cyst type. Axial cyst size, region of interest (ROI)-based apparent diffusion coefficient (ADC) and volumetric data, including cyst volume, volumetric apparent diffusion coefficient (vADC), and volumetric venous enhancement (vVE) were extracted and compared between the two groups. Univariate and multiple logistic regression was used to develop models for distinguishing between IPMNs and SCAs.
Volume and size of the cysts, vVE and vADC and ROI-ADC were significantly different between the two groups. Cyst volume was significantly larger in SCAs (median = 14.1cm, IQR 3.5-42.5) than in IPMNs (median = 2.5 cm, IQR 1.1-6) (p < 0.001). IPMNs had a higher volumetric ADC value in comparison to SCAs (2925 ± 294 × 10 mm/s vs 2521 ± 202 × 10 mm/s, p < 0.001). However, IPMNs had lower vVE values compared to SCAs (37 signal intensity (SI) vs 86 SI, p < 0.001). Area under the ROC Curve (AUC) of the model that included vADC and cyst volume had 95% accuracy in distinguishing between the two groups. In comparison, the AUC of the model that included ROI-ADC and axial cyst size had 84% accuracy in distinguishing between the two groups. A threshold of 2615 × 10 mm/s for volumetric ADC resulted in the identification of IPMNs from SCAs with sensitivity and specificity of 90.8% and 73.5%, respectively.
IPMNs had smaller cyst volume, higher volumetric ADC and lower volumetric VE values compared to SCAs. Volumetric multiparametric MRI could be useful in differentiating between the IPMN and SCA groups.
评估容积多参数 MRI 在鉴别胰腺导管内乳头状黏液性肿瘤（IPMNs）和浆液性囊腺瘤（SCs）中的作用。
根据囊型将纳入的患者（123 例胰腺囊性肿瘤（PCNs）≥10mm）分为两组。在两组之间提取和比较轴向囊大小、感兴趣区（ROI）-表观扩散系数（ADC）和容积数据，包括囊体积、容积表观扩散系数（vADC）和容积静脉增强（vVE）。使用单变量和多变量逻辑回归来建立鉴别 IPMNs 和 SCAs 的模型。
两组间的囊体积和大小、vVE 和 vADC 以及 ROI-ADC 均有显著差异。SCAs 的囊体积明显大于 IPMNs（中位数=14.1cm，IQR 3.5-42.5）（p<0.001）。与 SCAs 相比，IPMNs 的容积 ADC 值更高（2925±294×10mm/s 比 2521±202×10mm/s，p<0.001）。然而，与 SCAs 相比，IPMNs 的 vVE 值较低（37 信号强度（SI）比 86 SI，p<0.001）。包含 vADC 和囊体积的模型的 ROC 曲线下面积（AUC）在两组之间的鉴别准确率为 95%。相比之下，包含 ROI-ADC 和轴向囊大小的模型在两组之间的鉴别准确率为 84%。容积 ADC 的阈值为 2615×10mm/s 时，可识别出 IPMNs 和 SCAs，其敏感性和特异性分别为 90.8%和 73.5%。
与 SCAs 相比，IPMNs 的囊体积较小，容积 ADC 值较高，容积 VE 值较低。容积多参数 MRI 有助于鉴别 IPMN 和 SCA 组。
