Differentiation of benign and malignant solid pancreatic masses using magnetic resonance elastography with spin-echo echo planar imaging and three-dimensional inversion reconstruction: a prospective study.
Differentiation of benign and malignant solid pancreatic masses using magnetic resonance elastography with spin-echo echo planar imaging and three-dimensional inversion reconstruction: a prospective study.
复制标题
使用磁共振弹性成像结合自旋回波平面成像和三维反转重建来区分良性和恶性胰腺实性肿块：一项前瞻性研究
DOI：
10.1007/s00330-017-5062-y
复制
发表时间：
2018-03
影响因子：
5.9
通讯作者：
Guo Q
中科院分区：
文献类型：
--
作者：
Shi Y;Gao F;Li Y;Tao S;Yu B;Liu Z;Liu Y;Glaser KJ;Ehman RL;Guo Q
目的评价磁共振弹性成像(MRE)对胰腺肿块良恶性的诊断价值，并与血清CA19-9进行比较，着重鉴别胰腺导管腺癌(PDAC)和肿块性胰腺炎(MFP)。评估质量刚度和刚度比(以质量刚度与实质刚度之比计算)。结果恶性肿瘤54例(43例，PDAC)，良性肿瘤31例(24例，MFP)。在良、恶性肿块的鉴别诊断中，硬度比对良、恶性肿块的鉴别能力更好(AUC：0.912比0.845比0.702；P=0.026，P<；0.001)，尤其是对动脉导管未闭和MFP的鉴别(AUC值：0.955比0.882比0.745；P=0.026，P=0.003)。结论根据PDAC和MFP的力学性质，MRE为区分PDAC和MFP提供了一种有效的、定量的方法。3DMRE可用于胰腺实体瘤的硬度计算。·刚度比对区分PDAC和MFP的敏感性和特异性优于CA19-9。·建议将3D MRE纳入标准的MRI方案。
ObjectivesTo determine the diagnostic performance of MR elastography (MRE) and compare it with serum CA19-9 in differentiating malignant from benign pancreatic masses, with emphasis on differentiating between pancreatic ductal adenocarcinoma (PDAC) and mass-forming pancreatitis (MFP).MethodsWe performed a prospective, consecutive, 24-month study in 85 patients with solid pancreatic masses confirmed by histopathologic examinations. The mass stiffness and stiffness ratio (calculated as the ratio of mass stiffness to the parenchymal stiffness) were assessed. The diagnostic accuracy was analysed by calculating the area under the ROC curve (AUROC).ResultsThe final diagnosis included 54 malignant tumours (43 patients with PDAC) and 31 benign masses (24 patients with MFP). The stiffness ratio showed better diagnostic performance than the mass stiffness and serum CA19-9 for the differentiation between malignant and benign masses (AUC: 0.912 vs. 0.845 vs. 0.702;P =0.026,P <0.001) and, specifically, between PDAC and MFP (AUC: 0.955 vs. 0.882 vs. 0.745;P= 0.026,P =0.003). The sensitivity, specificity, and accuracy of stiffness ratio for the differentiation of PDAC and MFP were all higher than 0.9.ConclusionsMRE presents an effective and quantitative strategy for non-invasive differentiation between PDAC and MFP based on their mechanical properties.Key Points•3D MRE is useful for calculating stiffness of solid pancreatic tumours.•Stiffness ratio outperformed stiffness and CA19-9 for differentiating PDAC from MFP.•Incorporation of 3D MRE into a standard MRI protocol is recommended.
登录
查看更多内容
影响因子：
11.5
作者：
Armstrong, T;Packham, G;Iredale, JP
通讯作者：
Iredale, JP
影响因子：
4.4
作者：
Glaser, Kevin J.;Manduca, Armando;Ehman, Richard L.
通讯作者：
Ehman, Richard L.
影响因子：
19.7
作者：
HANLEY, JA;MCNEIL, BJ
通讯作者：
MCNEIL, BJ
影响因子：
5.5
作者：
Frampas, E;Morla, O;Meurette, G
通讯作者：
Meurette, G
影响因子：
3
作者：
Gijon de la Santa, Luis;Perez Retortillo, Jose Antonio;Marie Klein, Lea
通讯作者：
Marie Klein, Lea