MRI在G1/G2胰腺神经内分泌肿瘤病理分级及临床分期中的价值  

The value of MRI in pathological grading and clinical staging of G1/G2 pancreatic neuroendocrine neoplasms

作　　者：代博 王梅云 闫峰山 贺慧 窦社伟 张孝先[3] 谭红娜 DAO Bo;WANG Mei-yun;YAN Feng-shan(Department of Radiology Henan Provincial People's Hospital,Zhengzhou University People's Hospital,Henan University People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院/郑州大学人民医院/河南大学人民医院医学影像科,郑州450003 [2]河南省人民医院/郑州大学人民医院/河南大学人民医院病理科,郑州450003 [3]河南省肿瘤医院放射科,郑州450003

出　　处：《放射学实践》2022年第1期72-78,共7页Radiologic Practice

基　　金：河南省自然科学基金(编号:202300410081)。

摘　　要：目的:探讨MRI在G1/G2胰腺神经内分泌肿瘤(pNENs)病理分级及临床分期中的价值,寻找同时与G1/G2 pNENs病理分级及临床分期相关的MRI征象。方法:回顾性分析62例经手术病理证实为pNENs患者的临床及MRI资料,采用独立样本t检验、秩和检验、卡方检验、Fisher’s精确概率法等对pNENs不同病理分级及临床分期的临床表现及MRI征象进行比较。结果:边界是否清晰、肿瘤直径、有无周围组织浸润、增强后强化均匀与否、ADC比值在不同pNENs病理分级及临床分期间的差异均有统计学意义(P值均<0.05)。DWI信号及静脉期、延迟期MRI信号在不同病理分级间的差异均有统计学意义(P值均<0.05);性别、pNENs病灶呈囊实性、淋巴结转移及肝转移情况在不同临床分期间的差异均有统计学意义(P值均<0.05)。结论:边界不清、强化不均、周围组织浸润、较大的肿瘤直径、较低的ADC比值同时与pNENs较高的病理分级及临床分期相关,MRI检查有助于术前准确且全面评估pENEs的异质性,辅助患者的个性化治疗。Objective:To explore the value of MRI in predicting pathological grades and clinical stages of G1/G2 pancreatic neuroendocrine neoplasms(pNENs),and analyze the relevant MRI features.Methods:Clinical and MRI data of 62 patients with pNENs confirmed by post-surgery pathology were retrospectively collected in two centers, independent-samples T test, rank sum test, Chi-square test and Fisher’s exact probability test were used to compare the clinical and MRI features of pNENs in different pathological grades and clinical stages.Results:There were statistically significant differences in tumor boundary, tumor diameter, surrounding tissue infiltration, whether the enhancement was uniform or not, and ADC ratio in different pathological grades and clinical stages of pNENs(all P<0.05).MRI signals in venous phase and delayed phase and DWI signals showed statistically significant differences among different pathological grades(all P<0.05).There were statistically significant differences in gender, cystic or solid pNENs lesions, lymph node metastasis and liver metastasis among different clinical stages(all P<0.05).Conclusion:The unclear boundary, uneven enhancement, surrounding tissue infiltration, larger tumor diameter, and lower ADC ratio are associated with higher pathological grade and clinical stage of pNENs.MRI examination is helpful for accurate and comprehensive evaluation of the heterogeneity of pNENs before surgery, thus assisting in personalized treatment of patients.

关 键 词：胰腺肿瘤 神经内分泌肿瘤 磁共振成像 病理分级 临床分期 

分 类 号：R735.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]