Solid Pancreatic Tumors with Unilocular Cyst-Like Appearance on CT: Differentiation from Unilocular Cystic Tumors Using CT.
10.3348/kjr.2014.15.6.704
- Author:
Ju Hee LEE
1
;
Jae Ho BYUN
;
Jin Hee KIM
;
Seung Soo LEE
;
Hyoung Jung KIM
;
Moon Gyu LEE
Author Information
1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea. jhbyun@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Pancreatic neoplasm;
Neuroendocrine tumor;
Solid pseudopapillary tumor;
Contrast-enhanced CT
- MeSH:
Adenocarcinoma, Mucinous/diagnosis/*radiography;
Adult;
Aged;
Carcinoma, Papillary/diagnosis/*radiography;
Cystadenoma, Serous;
Diagnosis, Differential;
Female;
Humans;
Male;
Middle Aged;
Neuroendocrine Tumors/diagnosis/*radiography;
Pancreatic Neoplasms/diagnosis/*radiography;
Retrospective Studies;
Sensitivity and Specificity;
Tomography, X-Ray Computed
- From:Korean Journal of Radiology
2014;15(6):704-711
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To describe the computed tomography (CT) features of neuroendocrine tumors (NETs) and solid pseudopapillary tumors (SPTs) with unilocular cyst-like appearance, and to compare them with those of unilocular cystic tumors of the pancreas. MATERIALS AND METHODS: This retrospective study was approved by our Institutional Review Board, and informed consent was waived. We included 112 pancreatic tumors with unilocular cyst-like appearance on CT (16 solid tumors [nine NETs and seven SPTs] and 96 cystic tumors [45 serous cystadenomas, 30 mucinous cystic neoplasms, and 21 branch-duct intraductal papillary mucinous neoplasms]). Two radiologists reviewed the CT images in consensus to determine tumor location, long diameter, morphological features, wall thicknesses, ratio of wall thickness to tumor size, wall enhancement patterns, intratumoral contents, and accompanying findings. Fisher's exact test was used to analyze the results. RESULTS: All 16 solid tumors had perceptible walls (mean thickness, 2.7 mm; mean ratio of wall thickness to tumor size, 7.7%) with variable enhancement. Four NETs and seven SPTs had hemorrhage, calcifications, and/or mural nodules. Six CT findings were specific for solid tumors with unilocular cyst-like appearance: a thick (> 2 mm) wall, uneven thickness of the wall, high ratio of wall thickness to tumor size, hyper- or hypo-attenuation of the wall in the arterial and portal phase, and heterogeneous internal contents. When three or more of the above criteria were used, 100% specificity and 87.5-92% accuracy were obtained for solid tumors with unilocular cyst-like appearance. CONCLUSION: A combination of CT features was useful for distinguishing solid tumors with unilocular cyst-like appearance from unilocular cystic tumors of the pancreas.
