| 张朝阳.基于增强CT瘤体与瘤周CT值比值鉴别G3级胰腺神经内分泌瘤与胰腺神经内分泌癌[J].中国医学影像技术,2023,39(12):1843~1846 |
| 基于增强CT瘤体与瘤周CT值比值鉴别G3级胰腺神经内分泌瘤与胰腺神经内分泌癌 |
| Enhanced CT intratumor and peritumor CT value ratio for differentiating grade 3 pancreatic neuroendocrine tumor and pancreatic neuroendocrine cancer |
| 投稿时间：2023-07-20 修订日期：2023-09-18 |
| DOI：10.13929/j.issn.1003-3289.2023.12.023 |
| 中文关键词: 胰腺肿瘤 神经内分泌肿瘤 体层摄影术,X线计算机 |
| 英文关键词:pancreatic neoplasms neuroendocrine tumors tomography, X-ray computed |
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| 中文摘要: |
| 目的 观察基于增强CT瘤体与瘤周CT值比值鉴别G3级胰腺神经内分泌瘤（PNET）与胰腺神经内分泌癌（NEC）的价值。方法 回顾性分析39例接受腹部CT检查的胰腺神经内分泌肿瘤患者，根据病理结果将其纳入G3级PNET组（n=18）或PNEC组（n=21），比较组间一般资料、CT特征及动静脉期瘤体与瘤周CT值比值；以单因素logistic回归分析及受试者工作特征（ROC）曲线筛选鉴别G3级PNET与PNEC的有效指标，构建多因素logistic回归模型，分析各模型鉴别诊断效能。结果 组间患者年龄、性别、肿瘤大小、位置、成分、钙化，以及动脉期CT比值1（瘤体CT值/瘤体边缘至瘤周10 mm间CT值）及门静脉期CT比值1差异均无统计学意义（P均>0.05）；肿瘤均匀性、主胰管扩张、胆管扩张、胰管内侵犯、血管侵犯、动脉期CT比值2（瘤体CT值/瘤周10 mm至瘤周20 mm间CT值）及门静脉期CT比值2差异均有统计学意义（P均<0.05），且均为鉴别G3级PNET与PNEC的有效指标。分别以动脉期CT比值2+门静脉期CT比值2及肿瘤均匀性+动脉期CT比值2+门静脉期CT比值2构建的多因素logistic回归模型鉴别G3级PNET与PNEC的敏感度、特异度及曲线下面积（AUC）分别为76.20%、88.90%及0.899，肿瘤均匀性+动脉期CT比值2+门静脉期CT比值2模型鉴别的敏感度、特异度及AUC分别为85.70%、88.90%及0.926。结论 动脉期与门静脉期CT比值2可用于鉴别G3级PNET与PNEC；联合CT特征有助于提高鉴别诊断效能。 |
| 英文摘要: |
| Objective To observe the value of enhanced CT intratumor and peritumor CT value ratio for differentiating grade 3 pancreatic neuroendocrine tumor (PNET) and pancreatic neuroendocrine cancer (PNEC). Methods Totally 39 patients with pancreatic neuroendocrine neoplasm who underwent abdominal CT scanning were retrospectively enrolled and divided into G3 PNET group (n=18) or PNEC group (n=21) according to pathological results. The general data, CT features and CT value ratio of intratumor and peritumor based on arterial phase and portal vein phase enhanced CT were compared between groups. Univariate logistic regression analysis and receiver operating characteristic (ROC) curves were performed to screen the efficient indicator for differentiating G3 PNET and PNEC. Multivariate logistic regression was used to evaluate the differential diagnosis efficacy of the models. Results No significant difference of patients' age, gender, lesion size, location, composition, calcification nor CT value ratio1 (CT value of intratumor/CT value from tumor margin to 10 mm tumor margin size) based on arterial phase and portal vein phase was found between groups (all P>0.05). Significant differences of lesion uniformity, main pancreatic duct dilatation, bile duct dilatation, pancreatic duct invasion, vascular invasion and CT value ratio2 (CT value of intratumor/CT value from 10 mm to 20 mm tumor margin size) based on arterial phase and portal vein phase were found between groups (all P<0.05), and the above parameters were all efficient indicators for differentiating G3 PNET and PNEC. Multivariate logistic regression models were constructed using CT value ratio2 based on arterial phase and portal vein phase, as well as lesion uniformity combined with CT value ratio2 based on arterial phase and portal vein phase, respectively, and the sensitivity, specificity and the area under the curve of the former model was 76.20%, 88.90% and 0.899, of the later model was 85.70%, 88.90% and 0.926, respectively. Conclusion Enhanced CT intratumor and peritumor CT value ratio was useful for differentiating G3 PNET and PNEC, and the efficiency could be improved through combining CT features. |
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