Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd UH 0663, Indianapolis, IN, 46202, USA.
Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Abdom Radiol (NY). 2021 Sep;46(9):4245-4253. doi: 10.1007/s00261-021-03116-6. Epub 2021 May 20.
We aimed to answer several clinically relevant questions; (1) the interobserver agreement, (2) diagnostic performance of MRI with MRCP for (a) branch duct intraductal papillary mucinous neoplasms (BD-IPMN), mucinous cystic neoplasms (MCN) and serous cystic neoplasms (SCN), (b) distinguishing mucinous (BD-IPMN and MCN) from non-mucinous cysts, and (c) distinguishing three pancreatic cystic neoplasms (PCN) from post-inflammatory cysts (PIC).
A retrospective analysis was performed at a tertiary referral center for pancreatic diseases on 71 patients including 44 PCNs and 27 PICs. All PCNs were confirmed by surgical pathology to be 17 BD-IPMNs, 13 MCNs, and 14 SCNs. Main duct and mixed type IPMNs were excluded. Two experienced abdominal radiologists blindly reviewed all the images.
Sensitivity of two radiologists for BD-IPMN, MCN and SCN was 88-94%, 62-69% and 57-64%, specificity of 67-78%, 67-78% and 67-78%, and accuracy of 77-82%, 65-75% and 63-73%, respectively. There was 80% sensitivity, 63-73% specificity, 70-76% accuracy for distinguishing mucinous from non-mucinous neoplasms, and 73-75% sensitivity, 67-78% specificity, 70-76% accuracy for distinguishing all PCNs from PICs. There was moderate-to-substantial interobserver agreement (Cohen's kappa: 0.65).
Two experienced abdominal radiologists had moderate-to-high sensitivity, specificity, and accuracy for BD-IPMN, MCN, and SCN. The interobserver agreement was moderate-to-substantial. MRI with MRCP can help workup of incidental pancreatic cysts by distinguishing PCNs from PICs, and premalignant mucinous neoplasms from cysts with no malignant potential.
我们旨在回答几个临床相关问题；（1）观察者间的一致性，（2）MRI 与 MRCP 对（a）分支胰管内乳头状黏液性肿瘤（BD-IPMN）、黏液性囊腺瘤（MCN）和浆液性囊腺瘤（SCN）的诊断性能，（b）区分黏液性（BD-IPMN 和 MCN）和非黏液性囊肿，以及（c）区分三种胰腺囊性肿瘤（PCN）和炎性后囊肿（PIC）的诊断性能。
在一家胰腺疾病的三级转诊中心进行了回顾性分析，共纳入 71 例患者，包括 44 例 PCN 和 27 例 PIC。所有 PCN 均经手术病理证实为 17 例 BD-IPMN、13 例 MCN 和 14 例 SCN。主胰管和混合型 IPMN 被排除在外。两位有经验的腹部放射科医生对所有图像进行了盲法评估。
两位放射科医生对 BD-IPMN、MCN 和 SCN 的敏感度分别为 88-94%、62-69%和 57-64%，特异度分别为 67-78%、67-78%和 67-78%，准确率分别为 77-82%、65-75%和 63-73%。在区分黏液性和非黏液性肿瘤方面，敏感度为 80%，特异度为 63-73%，准确率为 70-76%；在区分所有 PCN 和 PIC 方面，敏感度为 73-75%，特异度为 67-78%，准确率为 70-76%。观察者间一致性为中度至高度（Cohen's kappa：0.65）。
两位有经验的腹部放射科医生对 BD-IPMN、MCN 和 SCN 具有中高度的敏感度、特异度和准确率。观察者间的一致性为中度至高度。MRI 联合 MRCP 有助于通过区分 PCN 和 PIC 以及区分有恶性潜能的黏液性肿瘤和无恶性潜能的囊肿来评估偶然发现的胰腺囊肿。
