Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;
Anticancer Res. 2022 Aug;42(8):3895-3903. doi: 10.21873/anticanres.15883.
BACKGROUND/AIM: We investigated whether the malignant switch of intraductal papillary mucinous neoplasm (IPMN) of the pancreas can be predicted by using the T1ϱ, T2, and apparent diffusion coefficient (ADC) values of cyst fluid.
We retrospectively analyzed the magnetic resonance (MR) images of 60 patients (26 males, 34 females, mean age 61 years) with branch-duct type and mixed-type IPMNs. The IPMNs were diagnosed clinically in 39 patients and histologically in 21 patients. The malignant potential was classified by MR imaging based on the international consensus guidelines for the management of IPMN established in 2017. Morphologically, 42 patients had "worrisome features" and three had "high-risk stigmata." Histologically, 14 lesions were diagnosed as low-grade dysplasia and seven as intermediate-grade dysplasia. The T1ϱ, T2, and ADC values of cyst fluid in each patient's largest cyst were measured on the same slice, avoiding solid components. Spearman's rank correlation test was used to determine the correlation between the morphological malignancy and the T1ϱ, T2, and ADC values. These values were also compared between the low-grade and intermediate-grade groups by Mann-Whitney U-test.
There was a significant rank-correlation between the morphological classification and T2 value (p=0.04). The T2 value of the intermediate-grade group was significantly higher than that of the low-grade group (p=0.03). No significant correlations were morphologically or histologically obtained regarding T1ϱ and ADC.
The T2 value of cyst fluid together with other MR-signs may be useful for predicting the malignant switch in IPMN of the pancreas.
背景/目的：我们研究了胰腺内导管乳头状黏液性肿瘤（IPMN）的恶性转化是否可以通过囊液的 T1ρ、T2 和表观扩散系数（ADC）值来预测。
我们回顾性分析了 60 例（男 26 例，女 34 例，平均年龄 61 岁）分支型和混合型 IPMN 患者的磁共振（MR）图像。39 例患者临床诊断为 IPMN，21 例患者组织学诊断为 IPMN。根据 2017 年国际 IPMN 管理共识指南，基于 MR 成像对恶性潜能进行分类。形态上，42 例患者有“令人担忧的特征”，3 例患者有“高危标志”。组织学上，14 个病变诊断为低级别异型增生，7 个病变诊断为中级别异型增生。在同一切片上测量每位患者最大囊肿的囊液 T1ρ、T2 和 ADC 值，避开实性成分。采用 Spearman 秩相关检验确定形态恶性与 T1ρ、T2 和 ADC 值之间的相关性。采用 Mann-Whitney U 检验比较低级别和中级别组之间的这些值。
形态分类与 T2 值之间存在显著的秩相关（p=0.04）。中级别组的 T2 值明显高于低级别组（p=0.03）。形态学或组织学上，T1ρ 和 ADC 与其他 MR 征象均无显著相关性。
囊液 T2 值结合其他 MR 征象可能有助于预测胰腺 IPMN 的恶性转化。
