A retrospective preliminary study of intrapancreatic late enhancement as a noteworthy imaging finding in the early stages of pancreatic adenocarcinoma
A retrospective preliminary study of intrapancreatic late enhancement as a noteworthy imaging finding in the early stages of pancreatic adenocarcinoma
复制标题
胰腺内晚期强化作为胰腺癌早期值得注意的影像学表现的回顾性初步研究
DOI：
10.1007/s00330-022-09388-w
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发表时间：
2023
影响因子：
5.9
通讯作者：
Niino Kazuho
中科院分区：
文献类型：
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作者：
Konno Yoshihiro;Sugai Yasuhiro;Kanoto Masafumi;Suzuki Keisuke;Hiraka Toshitada;Toyoguchi Yuki;Niino Kazuho
目的探讨胰腺腺癌（PAC）早期胰腺内晚期强化（ILE）的特征。方法选取2011年10月至2021年2月期间病理诊断为PAC的203例患者，其中32例在诊断前6个月至5年期间行诊断前腹部增强CT检查。预诊断CT的间接发现（IFs），包括ILE，被评估和检查各种临床数据和诊断时间间隔（TIDs）。定量评估检测到的ILE，并评估两名放射科医生对ILE意识对病变检测的影响及其观察者间的一致性。结果32例患者中有23例出现IFs。14例（63%）患者发生ILE， TID中位数为17个月（四分位数比[IQR]: 9.3-42.3）。单纯ILE 8例（35%），ILE伴局灶性胰腺实质萎缩（FPPA） 5例（22%），ILE伴主胰管异常（MPDA） 1例（4%）。单纯ILE患者的胰腺头部病变发生率明显高于FPPA或MPDA患者（p= 0.026）。ILE和ILE-胰腺对比区中位长轴直径分别为10 (IQR: 5-11) mm和24 (IQR: 17-33) HU。对ILE的认识使观察者多发现了两到三个胰腺头部病变，观察者之间的一致性从差一致性（k= 0.17）增加到中等一致性（k= 0.55）。结论ile是早期PAC检测的重要IF。•胰腺内晚期增强（ILE）是早期发现胰腺腺癌的重要间接发现。•无其他间接发现的ILE有望帮助发现胰腺头部病变。•关注ILE的图像评估可以增加病变检测，提高观察者之间的一致性。
ObjectiveTo characterize intrapancreatic late enhancement (ILE) observed in the early stages of pancreatic adenocarcinoma (PAC).MethodsAmong 203 patients pathologically diagnosed with PAC between October 2011 and February 2021, 32 patients with pre-diagnostic abdominal contrast-enhanced CT performed from 6 months to 5 years before the diagnosis were enrolled in this study. Indirect findings (IFs) on pre-diagnostic CT, including ILE, were evaluated and examined for various clinical data and time intervals to diagnosis (TIDs). The detected ILE was quantitatively evaluated, and the effect of ILE awareness on lesion detection by two radiologists and their interobserver agreement were assessed.ResultsAmong the 32 patients, 23 showed IFs. ILE was observed in 14 patients (63%), with a median TID of 17 months (interquartile ratio [IQR]: 9.3–42.3). ILE alone was observed in eight patients (35%), ILE with focal pancreatic parenchymal atrophy (FPPA) was observed in five patients (22%), and ILE with main pancreatic duct abnormalities (MPDA) was observed in one patient (4%). Pancreatic head lesions were significantly more frequent in patients with ILE alone than in patients with FPPA or MPDA (p= 0.026). The median long-axis diameters of the region with ILE and ILE-to-pancreas contrast were 10 (IQR: 5–11) mm and 24 (IQR: 17–33) HU, respectively. Awareness of ILE led observers to detect two or three more pancreatic head lesions, and interobserver agreement increased from poor agreement (k= 0.17) to moderate agreement (k= 0.55).ConclusionILE is a significant IF for early PAC detection.Key Points•Intrapancreatic late enhancement (ILE) is a significant indirect finding in the early detection of pancreatic adenocarcinoma.•ILE without other indirect findings is expected to help detect pancreatic head lesions.•Image evaluation focusing on ILE can increase lesion detection and improve the interobserver agreement.