Department of Radiology, Seoul National University Hospital, Seoul, South Korea.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
J Magn Reson Imaging. 2021 Oct;54(4):1177-1186. doi: 10.1002/jmri.27612. Epub 2021 Mar 28.
For surveillance of pancreatic intraductal papillary mucinous neoplasms (IPMNs), magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) is preferred over computed tomography, but the long acquisition time limits its use.
To investigate the diagnostic performance of abbreviated MRI with breath-hold (BH) three-dimensional MRCP (abbreviated MRI-BH) for malignant risk assessment of pancreatic IPMN.
Retrospective.
Two hundred and thirty-five patients with IPMNs (M:F = 115:120; mean age ± SD, 66 ± 9 years; typical imaging features with ≥2-year stability [N = 172] and histopathologically confirmed [N = 63]).
FIELD STRENGTH/SEQUENCE: 3.0 T/ abbreviated MRI-BH (single-shot fast spin-echo, T1W fat-suppressed gradient-echo sequence, and BH-3D-MRCP).
Abbreviated MRI-BH was reviewed by three reviewers, and its diagnostic performance was assessed using the predetermined scoring system. The diagnostic performance for the mural nodule detection was assessed. Additionally, diagnostic performance of abbreviated MRI was compared with that of full-sequence MRI.
Area under the receiver operating characteristic curve (AUC) with z-test, and linear-weighted kappa values.
Thirty-five patients had malignant IPMN. At a cut-off score ≥3, AUCs of abbreviated MRI-BH for detecting malignant IPMN were 0.959 for reviewer 1, 0.962 for reviewer 2, and 0.956 for reviewer 3. The sensitivity of reviewers 1, 2, and 3 was 97.1% for all, and the specificity was 85.5%, 86.0%, and 85.0%, respectively. Regarding mural nodule detection (N = 22), abbreviated MRI-BH demonstrated a sensitivity of 95.5% and a specificity of 88.3% for reviewer 1, a sensitivity of 86.4% and a specificity of 92.0% for reviewer 2, and a sensitivity of 86.4% and a specificity of 89.2% for reviewer 3. There were no significant differences between AUC of abbreviated MRI-BH and that of full-sequence MRI in the three reviewers (P > 0.05).
Abbreviated MRI-BH showed good diagnostic performance for detecting malignant IPMNs by using a predetermined scoring system.
3 TECHNICAL EFFICACY STAGE: 2.
对于胰腺导管内乳头状黏液性肿瘤（IPMN）的监测，磁共振成像（MRI）/磁共振胰胆管成像（MRCP）优于计算机断层扫描，但采集时间长限制了其应用。
研究屏气三维 MRCP（BH-MRCP）缩短的 MRI（abbreviated MRI-BH）在评估胰腺 IPMN 恶性风险方面的诊断性能。
回顾性。
235 例 IPMN 患者（男：女=115:120；平均年龄±标准差，66±9 岁；有≥2 年稳定性的典型影像学特征[N=172]和经组织病理学证实的[N=63]）。
磁场强度/序列：3.0T/abbreviated MRI-BH（单次激发快速自旋回波、T1W 脂肪抑制梯度回波序列和 BH-3D-MRCP）。
三位评估者对 abbreviated MRI-BH 进行了回顾，并使用预定的评分系统评估了其诊断性能。评估了壁结节检测的诊断性能。此外，还比较了 abbreviated MRI 的诊断性能与全序列 MRI 的诊断性能。
受试者工作特征曲线（ROC）下面积（AUC）的 z 检验和线性加权 kappa 值。
35 例患者患有恶性 IPMN。评分≥3 时，评估者 1、评估者 2 和评估者 3 的 abbreviated MRI-BH 检测恶性 IPMN 的 AUC 分别为 0.959、0.962 和 0.956。评估者 1、2 和 3 的敏感性均为 97.1%，特异性分别为 85.5%、86.0%和 85.0%。在壁结节检测（N=22）方面，abbreviated MRI-BH 对评估者 1 的敏感性为 95.5%，特异性为 88.3%，对评估者 2 的敏感性为 86.4%，特异性为 92.0%，对评估者 3 的敏感性为 86.4%，特异性为 89.2%。在三位评估者中，abbreviated MRI-BH 的 AUC 与全序列 MRI 之间无显著差异（P＞0.05）。
使用预定评分系统，abbreviated MRI-BH 显示出良好的检测恶性 IPMN 的诊断性能。
3 技术功效分级：2。
