G1与G2级胰腺神经内分泌肿瘤CT影像学特征比较分析  

Comparative analysis of computed tomography features in pancreatic neuroendocrine neoplasms with pathological Grade 1 and Grade 2

作　　者：汤江涛 杨光[1] 冀蒙[1] 汤靓[1] 侍力刚[1] 邵成伟[2] 邵成浩[1] 

机构地区：[1]第二军医大学附属长征医院普外科,上海200003 [2]第二军医大学附属长海医院影像科,上海200433

出　　处：《中国实用外科杂志》2017年第5期572-576,共5页Chinese Journal of Practical Surgery

摘　　要：目的对比分析G1与G2级胰腺神经内分泌肿瘤(pNENs)的术前CT影像特征,探讨其对pNENs病理学分级潜在的诊断价值。方法回顾性分析2010年1月至2015年12月第二军医大学附属长征医院和第二军医大学附属长海医院行动态CT增强扫描并手术切除的56例pNENs病例术前CT图像资料,比较G1与G2级pNENs病人的CT影像学特征,并通过ROC曲线分析肿瘤病灶CT绝对与相对强化值在鉴别G1与G2级病人中的诊断价值。结果 G2级pNENs病人的肿瘤最大径显著大于G1级病人[(4.2±3.3)cm vs.(3.0±1.4)cm,P=0.04],G2级病人发生浸润生长的比例显著高于G1级病人[(17/12)vs.(6/21),P<0.01]。CT影像学特征分析发现G1级病人动脉期、门静脉期的肿瘤绝对和相对强化程度及延迟期的肿瘤绝对强化程度均高于G2级病人(P<0.01)。ROC曲线分析发现门静脉期绝对强化值的ROC曲线下面积(AUC)达0.811(95%CI 0.700~0.922),特异度为0.655,敏感度为0.889。结论 G1与G2级pNENs病人具有不同的CT影像学特征,动脉期、门静脉期的肿瘤绝对和相对强化程度及延迟期的肿瘤绝对强化程度等可以用于术前判断G1与G2级pNENs。Objective To analyze the preoperative computed tomography （CT） features between G1 and G2 pancreatic neuroendocrine neoplasms （pNENs） and explore the diagnostic ability of distinguishing G1 from G2 pNENs. Methods The imaging data of 56 cases of pNENs who received preoperative enhancement CT between January 2010 and November 2015 in Changzheng Hospital and Changhai Hospital of Second Military Medical University were analyzed retrospectively. CT images of all the cases of pNENs were reviewed. Differences in clinic pathologic features and CT features between G1 and G2 pNENs were compared. ROC analysis was performed to explore the significance of relative and absolute CT value in the diagnosis of pNENs G1 and G2. Results The tumor sizes of G2 pNENs was greater than G1 [ （4.2±3.3） em vs. （3.0± 1.4） cm, P=0.04]. G2 pNENs were more likely to be invasion growth （P 〈 0.01）. Both absolute and relative CT value at arterial phase, portal phase and absolute CT value at delayed phase in G2 pNENs were significantly higher than those in G1 pNENs （P〈0.01）. Moreover, ROC analysis demonstrated that the AUC of absolute CT value at portal phase was 0.811 （95% CI 0.700 to 0.922）. The specificity and sensitivity were 0.655 and 0.889, respectively. Conclusion CT characteristics are different between G1 and G2 pNENs. Absolute and relative CT value at arterial phase, portal phase and absolute CT value at delayed phase could be used for preoperative assessment of G1 and G2 pNENs.

关 键 词：胰腺 神经内分泌肿瘤 病理学 分级 CT 

分 类 号：R6[医药卫生—外科学]