Wan Yamin, Hao Hui, Chen Yunjin, Zhang Yifan, Yue Qingmei, Li Zhizhen
Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Road, Zhengzhou, 450052, China.
Department of Radiology, Zhengzhou Central Hospital, Zhengzhou, 450000, China.
Insights Imaging. 2022 Sep 4;13(1):145. doi: 10.1186/s13244-022-01282-9.
Pancreatic neuroendocrine tumors (pNETs) are heterogeneous tumors from the pancreatic neuroendocrine system, and early diagnosis is important for tumor prognosis and treatment. In this study, we aimed to explore the diagnostic value of spectral CT combined with perfusion scanning in improving the detection rate of pNETs.
From December 2018 to December 2020, 58 patients with clinically suspected pNETs were prospectively enrolled in the study for one-stop spectral CT combined with perfusion scanning, 36 patients were confirmed with pNETs by histopathology. An independent cohort of 30 patients with pNETs who underwent routine pancreatic perfusion scanning in our hospital during the same period were retrospectively collected. The image characters of pNETs versus tumor-free pancreatic parenchymal were examined.
The detection rate of spectral CT combined with perfusion was 83.1-96.2%. CT values of the pNETs lesions under each single energy in the arterial phase were statistically higher than those of the adjacent normal pancreatic parenchyma. IC, WC and NIC, in the arterial phase of pNETs lesion were all statistically higher than those of the adjacent normal pancreatic parenchyma. The perfusion parameters of pNETs including BF, BV and MSI were significantly higher than those in normal parenchyma. The average effective radiation dose during the perfusion combined energy spectrum enhanced scanning process was 17.51 ± 2.18 mSv.
The one-stop spectral CT combined with perfusion scan improves the detection of pNETs according to morphological features, perfusion parameters and energy spectrum characters with a relatively small radiation dose.
胰腺神经内分泌肿瘤（pNETs）是源于胰腺神经内分泌系统的异质性肿瘤，早期诊断对肿瘤的预后和治疗至关重要。在本研究中，我们旨在探讨光谱CT联合灌注扫描在提高pNETs检出率方面的诊断价值。
2018年12月至2020年12月，前瞻性纳入58例临床疑似pNETs的患者进行一站式光谱CT联合灌注扫描，其中36例经组织病理学确诊为pNETs。回顾性收集同期在我院接受常规胰腺灌注扫描的30例pNETs患者组成独立队列。观察pNETs与无肿瘤胰腺实质的图像特征。
光谱CT联合灌注的检出率为83.1%-96.2%。pNETs病变在动脉期各单能量下的CT值均显著高于相邻正常胰腺实质。pNETs病变动脉期的IC、WC和NIC均显著高于相邻正常胰腺实质。pNETs的灌注参数包括BF、BV和MSI均显著高于正常实质。灌注联合能谱增强扫描过程中的平均有效辐射剂量为17.51±2.18 mSv。
一站式光谱CT联合灌注扫描根据形态学特征、灌注参数和能谱特征提高了pNETs的检出率，且辐射剂量相对较小。
