使用计算机断层扫描比较胰腺实性假乳头状瘤和伴有囊性改变的胰腺导管腺癌。

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING World journal of radiology Pub Date : 2024-06-28 DOI:10.4329/wjr.v16.i6.211
Shuai Ren, Li-Chao Qian, Xiao-Jing Lv, Ying-Ying Cao, Marcus J Daniels, Zhong-Qiu Wang, Li-Na Song, Ying Tian
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引用次数: 0

摘要

背景:胰腺实性假乳头状瘤(SPN目的:探讨计算机断层扫描(CT)在鉴别胰腺实性假乳头状瘤(SPN)和伴囊性改变的胰腺导管腺癌(PDAC)方面的价值:本研究回顾性分析了32例经病理诊断确诊为SPN的患者和14例经病理诊断确诊为有囊性变的PDAC患者的临床和影像学结果。研究进行了定量和定性分析,包括评估年龄、性别、肿瘤大小、形状、边缘、密度、增强模式、肿瘤的CT值、CT对比增强比、"浮云征"、钙化、主胰管扩张、胰腺萎缩、胰周侵犯或远端转移。采用多变量逻辑回归分析确定了区分SPN和伴囊性变的PDAC的相关特征,并绘制了接收器操作特征曲线,以评估各变量及其组合的诊断性能:与伴囊性变的PDAC相比,SPN的年龄较小(32岁对64岁,P<0.05),体积稍大(5.41厘米对3.90厘米,P<0.05)。与出现囊性改变的PDAC相比,SPN出现 "浮云征 "和胰周侵犯或远端转移的频率更高(均为P < 0.05)。两组患者在性别、肿瘤位置、形状、边缘、密度、主胰管扩张、钙化、胰腺萎缩、增强模式、肿瘤 CT 值或 CT 对比增强比等方面均无明显差异(均 P > 0.05)。该组合的接收器操作特征曲线下面积为 0.833(95% 置信区间:0.708-0.957),在鉴别 SPN 和 PDAC 伴囊性变方面的敏感性为 78.6%,特异性为 81.3%,准确性为 80.4%:结论:肿瘤体积较大、"浮云征"、胰周侵犯或远端转移是有用的CT成像特征,这些特征在SPN中更为常见,可能有助于鉴别SPN和伴囊性变的PDAC。
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Comparison between solid pseudopapillary neoplasms of the pancreas and pancreatic ductal adenocarcinoma with cystic changes using computed tomography.

Background: Solid pseudopapillary neoplasms of the pancreas (SPN) share similar imaging findings with pancreatic ductal adenocarcinoma with cystic changes (PDAC with cystic changes), which may result in unnecessary surgery.

Aim: To investigate the value of computed tomography (CT) in differentiation of SPN from PDAC with cystic changes.

Methods: This study retrospectively analyzed the clinical and imaging findings of 32 patients diagnosed with SPN and 14 patients diagnosed with PDAC exhibiting cystic changes, confirmed through pathological diagnosis. Quantitative and qualitative analysis was performed, including assessment of age, sex, tumor size, shape, margin, density, enhancement pattern, CT values of tumors, CT contrast enhancement ratios, "floating cloud sign," calcification, main pancreatic duct dilatation, pancreatic atrophy, and peripancreatic invasion or distal metastasis. Multivariate logistic regression analysis was used to identify relevant features to differentiate between SPN and PDAC with cystic changes, and receiver operating characteristic curves were obtained to evaluate the diagnostic performance of each variable and their combination.

Results: When compared to PDAC with cystic changes, SPN had a lower age (32 years vs 64 years, P < 0.05) and a slightly larger size (5.41 cm vs 3.90 cm, P < 0.05). SPN had a higher frequency of "floating cloud sign" and peripancreatic invasion or distal metastasis than PDAC with cystic changes (both P < 0.05). No significant difference was found with respect to sex, tumor location, shape, margin, density, main pancreatic duct dilatation, calcification, pancreatic atrophy, enhancement pattern, CT values of tumors, or CT contrast enhancement ratios between the two groups (all P > 0.05). The area under the receiver operating characteristic curve of the combination was 0.833 (95% confidence interval: 0.708-0.957) with 78.6% sensitivity, 81.3% specificity, and 80.4% accuracy in differentiation of SPN from PDAC with cystic changes.

Conclusion: A larger tumor size, "floating cloud sign," and peripancreatic invasion or distal metastasis are useful CT imaging features that are more common in SPN and may help discriminate SPN from PDAC with cystic changes.

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来源期刊
World journal of radiology
World journal of radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
自引率
8.00%
发文量
35
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