Analysis on the diagnostic value of preoperative magnetic resonance imaging for pancreatic mucinous cystic neoplasms
10.3760/cma.j.cn115667-20240327-00064
- VernacularTitle:胰腺黏液性囊性肿瘤术前磁共振成像诊断价值分析
- Author:
Xu FANG
1
;
Yun BIAN
1
;
Li WANG
1
;
Chengwei SHAO
1
;
Jianping LU
1
Author Information
1. 海军军医大学第一附属医院影像医学科，上海 200433
- Publication Type:Journal Article
- Keywords:
Pancreas;
Cystic neoplasm;
Mucinous;
Magnetic resonance imaging
- From:
Chinese Journal of Pancreatology
2024;24(6):419-424
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the diagnostic value of preoperative magnetic resonance imaging (MRI) in the diagnosis of pancreatic mucinous cystic neoplasm (MCN).Methods:The clinical, pathological and MRI imaging data of 128 patients with MCN diagnosed pathologically after surgical resection in the First Affiliated Hospital of Naval Medical University from March 2011 to February 2024 were retrospectively analyzed. According to the results of pre-opearative MRI diagnosis report, the patients were divided into correct diagnosis group and wrong diagnosis group, and the differences on the diagnostic doctors' subspecialty and MCN imaging features were compared between the two groups. According to the pathological grading criteria of MCN, the two groups were divided into benign group (low-grade dysplasia) and malignant group (high-grade dysplasia, invasive carcinoma), and the differences in imaging features between the two groups were compared. Imaging features included tumor location, tumor shape, monocyst or polycystic, unilocular or multilocular, tumor size, thickening of the wall or septa, hyperintensity on T 1WI, heterogeneity on T 2WI, enhanced mural nodule, main pancreatic duct dilation, and pancreatic parenchyma atrophy. Results:There were 53 cases (41.4%) in the correct diagnosis group and 75 cases (58.6%) in the wrong diagnosis group. There were 23 cases of fuzzy diagnosis (18.0%), 13 cases of serous cystadenoma (10.2%), 12 cases of pseudocyst (9.4%), 10 cases of intraductal papillary mucous neoplasm (7.8%), 9 cases of solid pseudopapillary neoplasm (7%), 3 cases of retention cyst (2.3%), 3 cases of pancreatic cancer (2.3%), and 2 cases of neuroendocrine neoplasm (1.6%). There was no significant difference between the two groups on the diagnostic doctors' subspecialty. The MCN being multilocular in the correct diagnosis group were more than that of the wrong diagnosis group and the difference was statistically significant ( P<0.05). There were 112 cases (87.5%) in the benign group and 16 cases (12.5%) in the malignant group. The MCN with being polycstic, thickening of the wall or septa, hyperintensity on T 1WI, enhanced mural nodule, main pancreatic duct dilation, and pancreatic parenchyma atrophy in the malignant group were more than that of the benign group, and the difference was statistically significant ( P<0.05). Conclusions:Preoperative MRI diagnosis of pancreatic MCN is difficult. The MCN being multilocular could significantly improve the accuracy of preoperative MRI diagnosis. Being polycystic, thickening of the wall or septa, hyperintensity on T 1WI, enhanced mural nodule, main pancreatic duct dilation, and pancreatic parenchyma atrophy are imaging features suggesting malignant MCN.
