BACKGROUND Significant correlation between lymphatic,microvascular,and perineural invasion(LMPI)and the prognosis of pancreatic neuroendocrine tumors(PENTs)was confirmed by previous studies.There was no previous study...BACKGROUND Significant correlation between lymphatic,microvascular,and perineural invasion(LMPI)and the prognosis of pancreatic neuroendocrine tumors(PENTs)was confirmed by previous studies.There was no previous study reported the relationship between magnetic resonance imaging(MRI)parameters and LMPI.AIM To determine the feasibility of using preoperative MRI of the pancreas to predict LMPI in patients with non-functioning PENTs(NFPNETs).METHODS A total of 61 patients with NFPNETs who underwent MRI scans and lymphadenectomy from May 2011 to June 2018 were included in this retrospective study.The patients were divided into group 1(n=34,LMPI negative)and group 2(n=27,LMPI positive).The clinical characteristics and qualitative MRI features were collected.In order to predict LMPI status in NF-PNETs,a multivariate logistic regression model was constructed.Diagnostic performance was evaluated by calculating the receiver operator characteristic(ROC)curve with area under ROC,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and accuracy.RESULTS There were significant differences in the lymph node metastasis stage,tumor grade,neuron-specific enolase levels,tumor margin,main pancreatic ductal dilatation,common bile duct dilatation,enhancement pattern,vascular and adjacent tissue involvement,synchronous liver metastases,the long axis of the largest lymph node,the short axis of the largest lymph node,number of the lymph nodes with short axis>5 or 10 mm,and tumor volume between two groups(P<0.05).Multivariate analysis showed that tumor margin(odds ratio=11.523,P<0.001)was a predictive factor for LMPI of NF-PNETs.The area under the receiver value for the predictive performance of combined predictive factors was 0.855.The sensitivity,specificity,PPV,NPV and accuracy of the model were 48.1%(14/27),97.1%(33/34),97.1%(13/14),70.2%(33/47)and 0.754,respectively.CONCLUSION Using preoperative MRI,ill-defined tumor margins can effectively predict LMPI in patients with NF-PNETs.展开更多
Objective:To assess if diffusion-weighted magnetic resonance(MR) imaging without apparent diffusion coefficient(ADC) values provides added diagnostic value in combination with conventional MR imaging in the detection ...Objective:To assess if diffusion-weighted magnetic resonance(MR) imaging without apparent diffusion coefficient(ADC) values provides added diagnostic value in combination with conventional MR imaging in the detection and characterization of small nodules in cirrhotic liver.Methods:Two observers retrospectively and independently analyzed 86 nodules(≤3 cm) certified pathologically in 33 patients with liver cirrhosis,including 48 hepatocellular carcinoma(HCC) nodules,13 high-grade dysplastic nodules(HDN),10 low-grade dysplastic nodules(LDNs) and 15 other benign nodules.All these focal nodules were evaluated with conventional MR images(T1-weighted,T2-weighted and dynamic gadolinium-enhanced images) and breath-hold diffusion-weighted images(DWI)(b=500s/mm2).The nodules were classified by using a scale of 1-3(1,not seen;3,well seen) on DWI for qualitative assessment.These small nodules were characterized by two radiologists.ADC values weren't measured.The diagnostic performance of the combined DWI-conventional images and the conventional images alone was evaluated using receiver operating characteristic(ROC) curves.The area under the curves(Az),sensitivity and specificity values for characterizing different small nodules were also calculated.Results:Among 48 HCC nodules,33(68.8%) were graded as 3(well seen),6(12.5%) were graded as 2(partially obscured),and 9 weren't seen on DWI.Among 13 HDNs,there were 3(23.1%) and 4(30.8%) graded as 3 and 2 respectively.Five(50%) of 10 benign nodules were partially obscured and slightly hyperintense.For 86 nodules,the average diagnostic accuracy of combined DWI-conventional images was 82.56%,which was increased significantly compared with conventional MR images with 76.17%.For HCC and HDN,the diagnostic accuracy of combined DWI-conventional images increased from 78.69% to 86.07%.Conclusions:Diffusion-weighted MR imaging does provide added diagnostic value in the detection and characterization of HDN and HCC,and it may not be helpful for LDN and regenerative nodule(RN) in cirrhotic liver.展开更多
基金Supported by Beijing Hospitals Authority Youth Program,No.QML20231103.
文摘BACKGROUND Significant correlation between lymphatic,microvascular,and perineural invasion(LMPI)and the prognosis of pancreatic neuroendocrine tumors(PENTs)was confirmed by previous studies.There was no previous study reported the relationship between magnetic resonance imaging(MRI)parameters and LMPI.AIM To determine the feasibility of using preoperative MRI of the pancreas to predict LMPI in patients with non-functioning PENTs(NFPNETs).METHODS A total of 61 patients with NFPNETs who underwent MRI scans and lymphadenectomy from May 2011 to June 2018 were included in this retrospective study.The patients were divided into group 1(n=34,LMPI negative)and group 2(n=27,LMPI positive).The clinical characteristics and qualitative MRI features were collected.In order to predict LMPI status in NF-PNETs,a multivariate logistic regression model was constructed.Diagnostic performance was evaluated by calculating the receiver operator characteristic(ROC)curve with area under ROC,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and accuracy.RESULTS There were significant differences in the lymph node metastasis stage,tumor grade,neuron-specific enolase levels,tumor margin,main pancreatic ductal dilatation,common bile duct dilatation,enhancement pattern,vascular and adjacent tissue involvement,synchronous liver metastases,the long axis of the largest lymph node,the short axis of the largest lymph node,number of the lymph nodes with short axis>5 or 10 mm,and tumor volume between two groups(P<0.05).Multivariate analysis showed that tumor margin(odds ratio=11.523,P<0.001)was a predictive factor for LMPI of NF-PNETs.The area under the receiver value for the predictive performance of combined predictive factors was 0.855.The sensitivity,specificity,PPV,NPV and accuracy of the model were 48.1%(14/27),97.1%(33/34),97.1%(13/14),70.2%(33/47)and 0.754,respectively.CONCLUSION Using preoperative MRI,ill-defined tumor margins can effectively predict LMPI in patients with NF-PNETs.
基金supported by the Capital Medical Development Foundation(Grant No.2011-2015-02)the National Basic Research Program of China (973 Program)(Grant No.2011CB707705)the Capital Characteristic Clinical Application Research(Grant No.Z121107001012115)
文摘Objective:To assess if diffusion-weighted magnetic resonance(MR) imaging without apparent diffusion coefficient(ADC) values provides added diagnostic value in combination with conventional MR imaging in the detection and characterization of small nodules in cirrhotic liver.Methods:Two observers retrospectively and independently analyzed 86 nodules(≤3 cm) certified pathologically in 33 patients with liver cirrhosis,including 48 hepatocellular carcinoma(HCC) nodules,13 high-grade dysplastic nodules(HDN),10 low-grade dysplastic nodules(LDNs) and 15 other benign nodules.All these focal nodules were evaluated with conventional MR images(T1-weighted,T2-weighted and dynamic gadolinium-enhanced images) and breath-hold diffusion-weighted images(DWI)(b=500s/mm2).The nodules were classified by using a scale of 1-3(1,not seen;3,well seen) on DWI for qualitative assessment.These small nodules were characterized by two radiologists.ADC values weren't measured.The diagnostic performance of the combined DWI-conventional images and the conventional images alone was evaluated using receiver operating characteristic(ROC) curves.The area under the curves(Az),sensitivity and specificity values for characterizing different small nodules were also calculated.Results:Among 48 HCC nodules,33(68.8%) were graded as 3(well seen),6(12.5%) were graded as 2(partially obscured),and 9 weren't seen on DWI.Among 13 HDNs,there were 3(23.1%) and 4(30.8%) graded as 3 and 2 respectively.Five(50%) of 10 benign nodules were partially obscured and slightly hyperintense.For 86 nodules,the average diagnostic accuracy of combined DWI-conventional images was 82.56%,which was increased significantly compared with conventional MR images with 76.17%.For HCC and HDN,the diagnostic accuracy of combined DWI-conventional images increased from 78.69% to 86.07%.Conclusions:Diffusion-weighted MR imaging does provide added diagnostic value in the detection and characterization of HDN and HCC,and it may not be helpful for LDN and regenerative nodule(RN) in cirrhotic liver.
