AIM： To identify multi-detector computed tomography （MDCT） features most predictive of serous cystadenomas （SCAs）, correlating with histopathology, and to study the impact of cyst size and MDCT technique on reade...AIM： To identify multi-detector computed tomography （MDCT） features most predictive of serous cystadenomas （SCAs）, correlating with histopathology, and to study the impact of cyst size and MDCT technique on reader performance. METHODS： The MDCT scans of 164 patients with surgically verified pancreatic cystic lesions were reviewed by two readers to study the predictive value of various morphological features for establishing a diagnosis of SCAs. Accuracy in lesion characterization and reader confidence were correlated with lesion size （≤3 cm or 〉≥3 cm） and scanning protocols （dedicated vs routine）. RESULTS： 28/164 cysts （mean size, 39 mm; range, 8-92 mm） were diagnosed as SCA on pathology. The MDCT features predictive of diagnosis of SCA were microcystic appearance （22/28, 78.6%）, surface Iobulations （25/28, 89.3%） and central scar （9/28, 32.4%）. Stepwise logistic regression analysis showed that only microcystic appearance was significant for CT diagnosis of SCA （P = 0.0001）. The sensitivity, specificity and PPV of central scar and of combined microcystic appearance and Iobulations were 32.4%/100%/100% and 68%/100%/100%, respectively. The reader confidence was higher for lesions 〉 3 cm （P = 0.02） and for MDCT scans performed using thin collimation （1.25-2.5 mm） compared to routine 5 mm collimation exams （P 〉 0.05）. CONCLUSION： Central scar on MDCT is diagnostic of SCA but is seen in only one third of SCAs. Microcystic morphology is the most significant CT feature in diagnosis of SCA. A combination of microcystic appearance and surface Iobulations offers accuracy comparable to central scar with higher sensitivity.展开更多
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...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。展开更多
文摘AIM： To identify multi-detector computed tomography （MDCT） features most predictive of serous cystadenomas （SCAs）, correlating with histopathology, and to study the impact of cyst size and MDCT technique on reader performance. METHODS： The MDCT scans of 164 patients with surgically verified pancreatic cystic lesions were reviewed by two readers to study the predictive value of various morphological features for establishing a diagnosis of SCAs. Accuracy in lesion characterization and reader confidence were correlated with lesion size （≤3 cm or 〉≥3 cm） and scanning protocols （dedicated vs routine）. RESULTS： 28/164 cysts （mean size, 39 mm; range, 8-92 mm） were diagnosed as SCA on pathology. The MDCT features predictive of diagnosis of SCA were microcystic appearance （22/28, 78.6%）, surface Iobulations （25/28, 89.3%） and central scar （9/28, 32.4%）. Stepwise logistic regression analysis showed that only microcystic appearance was significant for CT diagnosis of SCA （P = 0.0001）. The sensitivity, specificity and PPV of central scar and of combined microcystic appearance and Iobulations were 32.4%/100%/100% and 68%/100%/100%, respectively. The reader confidence was higher for lesions 〉 3 cm （P = 0.02） and for MDCT scans performed using thin collimation （1.25-2.5 mm） compared to routine 5 mm collimation exams （P 〉 0.05）. CONCLUSION： Central scar on MDCT is diagnostic of SCA but is seen in only one third of SCAs. Microcystic morphology is the most significant CT feature in diagnosis of SCA. A combination of microcystic appearance and surface Iobulations offers accuracy comparable to central scar with higher sensitivity.
文摘目的: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。
