Neuroendocrine neoplasms of the pancreas at dynamic enhanced CT: comparison between grade 3 neuroendocrine carcinoma and grade 1/2 neuroendocrine tumour
Neuroendocrine neoplasms of the pancreas at dynamic enhanced CT: comparison between grade 3 neuroendocrine carcinoma and grade 1/2 neuroendocrine tumour
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DOI：
10.1007/s00330-014-3532-z
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发表时间：
2015-03-01
影响因子：
5.9
通讯作者：
Hong, Seung-Mo
中科院分区：
文献类型：
--
作者：
Kim, Dong Wook;Kim, Hyoung Jung;Hong, Seung-Mo
旨在确定区分 3 级神经内分泌癌和 1/2 级神经内分泌肿瘤的 CT 特征。本研究纳入了 161 名经手术证实患有胰腺神经内分泌肿瘤的患者。检查病理学载片以确定肿瘤等级。 CT图像分析包括大小、形态、钙化、切缘、胰管扩张、胆管扩张、血管侵犯、动脉强化率、汇管强化率。我们使用2 cm、3 cm和4 cm作为肿瘤大小的截断值以及0.9和1.1的增强比来确定敏感性和特异性。病理学分析在161名患者中发现了167个病变。 154 个病变 (92%) 为 1/2 级，13 个病变 (8%) 为 3 级。汇管增强比 (< 1.1) 在区分 3 级和 1/2 级方面表现出高敏感性和特异性，分别为 92.3% 和 80.5%。它显示出最高的比值比 (49.60)，其次是边界不清、大小 (> 3 cm)、胆管扩张和血管侵犯。当这五个标准中的至少两个结合使用时，诊断 3 级的敏感性和特异性分别为 92.3 % (12/13) 和 87.7 % (135/154)。通过使用特定的 CT 结果，3 级可以与 1/2 级区分开，具有较高的诊断准确性，从而实现适当的影像分期。a 欧元神经内分泌癌应与 神经内分泌肿瘤。aEuro cent 神经内分泌癌可与动态 CT 上的神经内分泌肿瘤区分开来。aEuro cent 神经内分泌癌在门静脉期 CT 上显示等增强或低增强。
To identify the CT features in differentiating grade 3 neuroendocrine carcinomas from grade 1/2 neuroendocrine tumours.This study included 161 patients with surgically confirmed pancreatic neuroendocrine neoplasms. Pathology slides were reviewed to determine the tumour grade. CT image analysis included size, pattern, calcification, margin, pancreatic duct dilatation, bile duct dilatation, vascular invasion, arterial enhancement ratio, and portal enhancement ratio. We used 2 cm, 3 cm, and 4 cm as cutoff values of tumour size and 0.9 and 1.1 of enhancement ratio to determine the sensitivity and specificity.Pathology analysis identified 167 lesions in 161 patients. 154 lesions (92 %) were grade 1/2 and 13 (8 %) were grade 3. Portal enhancement ratio (< 1.1) showed high sensitivity and specificity 92.3 % and 80.5 %, respectively in differentiating grade 3 from grade 1/2. It showed the highest odds ratio (49.60), followed by poorly defined margin, size (> 3 cm), bile duct dilatation, and vascular invasion. When at least two of these five criteria were used in combination, the sensitivity and specificity for diagnosing grade 3 were 92.3 % (12/13) and 87.7 % (135/154), respectively.By using specific CT findings, grade 3 can be differentiated from grade 1/2 with a high diagnostic accuracy leading to an appropriate imaging staging.aEuro cent Neuroendocrine carcinomas should be differentiated from neuroendocrine tumours.aEuro cent Neuroendocrine carcinomas can be differentiated from neuroendocrine tumours on dynamic CT.aEuro cent Neuroendocrine carcinomas show iso- or hypo-enhancement on portal venous phase CT.