Department of Diagnostic Radiology, San Gerardo Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy.
Department of Diagnostic Radiology, San Gerardo Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy.
Radiography (Lond). 2021 May;27(2):554-560. doi: 10.1016/j.radi.2020.11.016. Epub 2020 Dec 4.
The present study aims to compare low-kV CT reconstructed with MBIR technique with MRI in detecting high-risk stigmata and worrisome features in patients with pancreatic cystic lesions.
We retrospective enrolled 75 patients who underwent low-kV CT with contrast media injection for general abdominal disorders and MRI with MRCP sequences. The reviewer, blinded to clinical and histopathological data, recorded the overall number of pancreatic cystic lesions, size, location, presence of calcifications, septa, or solid enhancing or non-enhancing components, main pancreatic duct (MPD) communication, and MPD dilatation. Mean differences with 95% limits of agreement, ICC, and κ statistics were used to compare CT and MRI.
More pancreatic cystic lesions were detected with MRI than with CT, however, the ICC value of 0.81 suggested a good agreement. According to the evaluated target lesion, a very good agreement (ICC = 0.98) was found regarding the diameter (21.4 mm CT vs 21.8 mm MRI), the location (κ = 0.90), the detection of MPD dilatation (κ = 1), the presence of septa (κ = 0.86) and the MPD communication (κ = 0.87). A moderate agreement on the assessment of enhanced components was noted (κ = 0.44), while there was only a fair agreement about the presence of calcifications (κ = 0.87).
MDCT can be considered almost equivalent to MRI with MRCP in the evaluation of worrisome features and high-risk stigmata, offering detailed morphologic features helpful for their characterization.
Even if MRI is considered the reference standard in pancreatic cystic lesions characterization, CT can be considered a useful tool as a first-line imaging technique to identify worrisome features and high-risk stigmata.
本研究旨在比较低千伏 CT 重建的 MBIR 技术与 MRI 在检测胰腺囊性病变高危特征和令人担忧的特征。
我们回顾性纳入了 75 例因腹部疾病接受低千伏 CT 增强扫描和 MRI 及 MRCP 序列检查的患者。盲法评估者记录胰腺囊性病变的总数、大小、位置、钙化、分隔、实性强化或非强化成分、主胰管（MPD）沟通和 MPD 扩张的存在情况。使用均数差值和 95%一致性界限、ICC 和κ统计量来比较 CT 和 MRI。
MRI 比 CT 检测到更多的胰腺囊性病变，但 ICC 值为 0.81，提示存在良好的一致性。根据评估的靶病变，在直径（CT 为 21.4mm，MRI 为 21.8mm）、位置（κ=0.90）、MPD 扩张的检测（κ=1）、分隔的存在（κ=0.86）和 MPD 沟通（κ=0.87）方面，发现存在极好的一致性。在评估强化成分方面，存在中度一致性（κ=0.44），而在钙化的存在方面，仅存在适度一致性（κ=0.87）。
MDCT 可与 MRI 及 MRCP 相当，用于评估高危特征和可疑特征，提供有助于其特征描述的详细形态学特征。
尽管 MRI 被认为是胰腺囊性病变特征描述的参考标准，但 CT 可被视为一种有用的工具，可作为一种一线成像技术，用于识别高危特征和可疑特征。
