摘要
目的比较胰腺神经内分泌肿瘤(pancreatic neuroendocrine tumor,pNET)与胰腺导管腺癌(pancreatic ductal adenocarcinoma,pDAC)的超声影像学特征及不同病理级别pNET超声特征差异。方法回顾性分析2010年1月至2019年3月中山大学附属第一医院67例病理确诊为pNET患者(pNET组)和同期82例病理确诊为pDAC患者(pDAC组)的超声影像学资料,比较两组常规超声特征及超声造影表现的差异。对50例有明确病理分级(G1、G2、G3)的pNET病灶,比较不同病理级别pNET间超声影像学特征的差异。结果①pNET组与pDAC组超声影像学特征比较:两组在病灶分布、病灶大小、回声、边界、血流信号、钙化以及合并主胰管扩张、肝转移、血管受累、三期增强水平及坏死无增强区方面差异有统计学意义(均P<0.05)。将上述超声特征经二元逻辑回归分析构建的包括病灶血流信号、合并主胰管扩张、肝转移及动脉期和静脉期增强水平等参数的回归模型,其诊断pNET的敏感性为0.988,特异性为0.791,ROC曲线下面积为0.951,95%CI为0.920~0.983。②不同病理级别pNET超声影像学特征比较:G1、G2、G3三组在合并肝转移及静脉期增强水平方面差异有统计学意义(均P<0.05)。G1pNET仅10.5%(2/19)存在肝转移,而47.8%(11/23)G2 pNET及62.5%(5/8)G3 pNET存在肝转移;静脉期78.9%(15/19)G1病灶呈高或等增强,而100%(8/8)G3病灶消退为低增强。结论联合多项超声影像学特征有助于鉴别pNET与pDAC,且不同病理级别pNET在超声影像学表现上存在一定差异。
Objective To compare the characteristics of ultrasonic imaging between pancreatic neuroendocrine tumor(pNET)and pancreatic ductal adenocarcinoma(pDAC),and to identify the ultrasonic characteristics in different pathological grades of pNETs.Methods The ultrasonic imaging data of 67 patients with pathologically confirmed pNETs and 82 patients with pathologically confirmed pDACs from the First Affiliated Hospital of Sun Yat-sen University from January 2010 to March 2019 were retrospectively analyzed.Differences in conventional ultrasonic characteristics and CEUS manifestations between the two groups were compared.Fifty pNET lesions were confirmed with pathological grades G1,G2 and G3.Ultrasonic characteristics of the 3 pathological grades were also compared.Results①Comparison of ultrasonic imaging characteristics between pNET and pDAC showed that:there were statistically significant differences between the two groups in lesion distribution,lesion size,echo,boundary,signal of blood flow,calcification,dilatation of main pancreatic duct,liver metastasis,vascular involvement,CEUS enhancement in the three phases and non-enhancement area of necrosis(all P<0.05).The binary logistic regression model was built including the signal of blood flow,dilation of main pancreatic duct,liver metastasis and enhancementin arterial and venous phases.The diagnostic model for pNET had 0.988 in sensitivity,0.791 in specificity,and the area under the ROC curve at 0.951,95%CI being(0.920,0.983).②Comparison of the characteristics of ultrasonic imaging between the pNETs derived from the three pathological grades:there were statistically significant differences among the three groups with the liver metastasis and the enhancement in venous phase(both P<0.05).Only 10.5%(2/19)of G1 pNETs had liver metastasis,while 47.8%(11/23)of G2 and 62.5%(5/8)of G3 pNETs had liver metastasis.In venous phase,78.9%(15/19)of G1 pNETs showed hyper-or iso-enhancement,while 100%(8/8)of G3 lesions showed hypo-enhancement.Conclusions The combination of features from multiple ultrasonic imaging may help to differentiate pNET from pDAC.There are certain differences in ultrasonic imaging features in pNETs at different pathological grades.
作者
黄京智
徐明
陈洁
张晓儿
谢晓燕
谢晓华
Huang Jingzhi;Xu Ming;Chen Jie;Zhang Xiao′er;Xie Xiaoyan;Xie Xiaohua(Department of Medical Ultrasonics,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;Department of Gastroenterology,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2020年第3期242-248,共7页
Chinese Journal of Ultrasonography
基金
国家自然科学基金(81530055)。
关键词
超声检查
超声造影
胰腺神经内分泌肿瘤
胰腺导管腺癌
Ultrasonography
Contrast-enhanced ultrasound
Pancreatic neuroendocrine tumor
Pancreatic ductal denocarcinoma
