MSCT在胰腺浆液性微囊腺瘤、乏血供神经内分泌肿瘤中的鉴别诊断价值及影像特点分析

The value and imaging characteristics of MSCT in the differential diagnosis of pancreatic serous microcystic adenoma and hypoplastic neuroendocrine tumor

目的:分析多层螺旋CT(multi-slice spiral CT,MSCT)在胰腺浆液性微囊腺瘤(serous microcystic adenoma of the pancreas,SCAP)、胰腺乏血供神经内分泌肿瘤(pancreatichypo-vascularizedneuroendocrinetumors,hypo-PNETs)中的鉴别效果与其影像特点。方法:回顾性分析2021年8月—2022年8月莒县碁山镇卫生院收治的经病理检查证实的78例SCAP与hypo-PNETs患者的临床资料,全部患者均进行MSCT检查,以病理检查结果为“金标准”,统计MSCT检查的诊断符合率;另分析SCAP与hypo-PNETs的影像特点差异。结果:病理检查显示:78例患者中,SCAP共40例,hypo-PNETs共38例。MSCT检查共检出39例SCAP,38例hypoPNETs,总诊断符合率为98.72%(77/78);hypo-PNETs边界不清占比为77.50%(31/40)、无纤维间隔占比为80.00%(32/40)、动脉期强化占比为87.50%(35/40)、无浮云征占比为75.00%(30/38)、有转移或侵犯占比为80.00%(32/40),高于SCAP患者的21.05%(8/38)、26.32%(10/38)、44.74%(17/38)、26.68%(9/38)、0.00%,差异有统计学意义(P<0.05);而两者的部位、形态、胰管扩张、密度、钙化情况相比,差异无统计学意义(P>0.05)。结论:MSCT在SCAP、hypo-PNETs鉴别诊断中效果显著,而SCAP、hypo-PNETs两者的影像学特点存在较大差异,可为临床提供可靠的参考,值得临床大力推广。

Objective To analyze the differential effect and imaging characteristics of multi-slice spiral CT(MSCT)in pancreatic serous microcystic adenoma(SCAP)and pancreatic hypo-vascularized neuroendocrine tumors(hypo-PNETs).Methods The clinical data of 78 patients with SCAP and hypo-PNETs confirmed by pathological examination admitted to Juxian Qishan Town Health Center from August 2021 to August 2022 were retrospectively analyzed.All patients underwent MSCT examination,using pathological examination results as the"gold standard"to explore the diagnostic accuracy of MSCT examination;In addition,the differences in image characteristics between SCAP and hypo-PNETs were analyzed.Results Pathological examination showed that among the 78 patients,there were 40 cases of SCAP and 38 cases of hypo-PNETs.MSCT detected 39 cases of SCAP and 38 cases of hyper-PNETs,with a total diagnostic accuracy of 98.72%(77/78);The proportion of unclear boundaries,non fibrous septa,arterial phase enhancement,non floating cloud sign,metastasis or invasion was 77.50%(31/40),80.00%(32/40),87.50%(35/40),75.00%(30/38),and 80.00%(32/40),respectively,higher than 21.05%(8/38),26.32%(10/38),44.74%(17/38),26.68%(9/38),and 0.00%in patients with SCAP,the difference is statistically significant(P<0.05);There was no significant difference in the location,morphology,pancreatic duct dilation,density,and calcification condition between the two groups(P>0.05).Conclusion MSCT has a significant effect in the differential diagnosis of SCAP and hypo-PNETs,but there are significant differences in the imaging characteristics between SCAP and hypo-PNETs,which can provide reliable reference for clinical practice and is worth promoting in clinical practice.