Differentiation of pancreatic neuroendocrine carcinoma from pancreatic ductal adenocarcinoma using magnetic resonance imaging: The value of contrast-enhanced and diffusion weighted imaging.
Differentiation of pancreatic neuroendocrine carcinoma from pancreatic ductal adenocarcinoma using magnetic resonance imaging: The value of contrast-enhanced and diffusion weighted imaging.
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DOI：
10.18632/oncotarget.17309
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发表时间：
2017-06-27
期刊：
影响因子：
--
通讯作者：
Zhuge X
中科院分区：
文献类型：
--
作者：
Guo C;Chen X;Wang Z;Xiao W;Wang Q;Sun K;Zhuge X
胰腺神经内分泌癌（PNEC）常被误诊为胰腺导管腺癌（PDAC）。这项回顾性研究使用磁共振成像（MRI）（包括对比增强（CE）和弥散加权成像（DWI））区分PNEC和PDAC。比较37例PDAC和13例PNEC的临床数据和MRI表现，包括T1/T2信号、肿瘤边界、大小、强化程度和表观扩散系数（ADC）。PDAC中边界的定义比PNEC更差（97.3% vs. 61.5%，p<0.01）。PNEC中动脉期（38.5% vs. 0.0）、门脉期（46.2% vs. 2.7%）和延迟期（46.2% vs. 5.4%）的高/等信号比PDAC更常见（均p<0.01）。淋巴结转移（97.3% vs.61.5%，p<0.01）和局部浸润/远处转移（86.5% vs.46.2%，p<0.01）在PDAC中较PNEC多见。在动脉期和门脉期，PNEC的CE-MRI增强程度高于PDAC（p<0.01）。PNEC的ADC值明显低于正常胰腺组织（p<0.01）和PDAC（p<0.01）。动脉期及门脉期信号强度比和ADC值显示出最大的受试者工作特征曲线下面积，并具有良好的敏感性（92.1%~ 97.2%）和特异性（76.9%~ 92.3%）。因此，动脉期、门脉期强化程度及ADC值可作为MRI鉴别PNEC与PDAC的依据。
Pancreatic neuroendocrine carcinoma (PNEC) is often misdiagnosed as pancreatic ductal adenocarcinoma (PDAC). This retrospective study differentiated PNEC from PDAC using magnetic resonance imaging (MRI), including contrast-enhanced (CE) and diffusion-weighted imaging (DWI). Clinical data and MRI findings, including the T1/T2 signal, tumor boundary, size, enhancement degree, and apparent diffusion coefficient (ADC), were compared between 37 PDACs and 13 PNECs. Boundaries were more poorly defined in PDAC than PNEC (97.3% vs. 61.5%, p<0.01). Hyper-/isointensity was more common in PNEC than PDAC at the arterial (38.5% vs. 0.0), portal (46.2% vs. 2.7%) and delayed phases (46.2% vs. 5.4%) (all p<0.01). Lymph node metastasis (97.3% vs. 61.5%, p<0.01) and local invasion/distant metastasis (86.5% vs. 46.2%, p<0.01) were more common in PDAC than PNEC. Enhancement degree via CE-MRI was higher in PNEC than PDAC at the arterial and portal phases (p<0.01). PNEC ADC values were lower than those of normal pancreatic parenchyma (p<0.01) and PDAC (p<0.01). Arterial and portal phase signal intensity ratios and ADC values showed the largest areas under the receiver operating characteristic curve and good sensitivities (92.1%–97.2%) and specificities (76.9%–92.3%) for differentiating PNEC from PDAC. Thus the enhancement degree at the arterial and portal phases and the ADC values may be useful for differentiating PNEC from PDAC using MRI.
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