| 张海峰,朱翰林,张梅花,余日胜,冯波.MRI灰阶比值对G2、G3级胰腺神经内分泌肿瘤和胰腺癌的鉴别诊断价值[J].浙江中西医结合杂志,2023,33(1): |
| MRI灰阶比值对G2、G3级胰腺神经内分泌肿瘤和胰腺癌的鉴别诊断价值 |
| Differential diagnostic value of MRI signal intensity ratio for G2、G3 grade pancreatic neuroendocrine tumors and pancreatic cancer |
| 投稿时间：2022-03-28 修订日期：2022-06-13 |
| DOI： |
| 中文关键词: 灰阶比值 磁共振 神经内分泌肿瘤 胰腺癌 |
| 英文关键词:gray scale ratio MRI pancreatic neuroendocrine tumor pancreatic cancer |
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| 中文摘要: |
| 目的 探讨MRI灰阶比值在G2、G3级胰腺神经内分泌肿瘤（PNET）与胰腺癌（PDAC）鉴别诊断中的价值。方法 回顾性分析经病理证实的37例G2、G3级PNET 与 52例PDAC的MRI增强图像，通过格林蓝德阅片系统灰阶值测量软件，测量增强各期瘤体和同层面正常胰腺的灰阶值，计算瘤体与正常胰腺灰阶比值，采用t检验对两组数值进行分析，通过受试者工作曲线得出阈值，并建立联合预测模型。结果 37例PNET与52例PDAC T1平扫、动脉期、实质期、静脉期、延迟期的灰阶比值分别为0.76±0.17和0.81±0.26（t=-0.91,p=0.36）、1.03±0.30和0.65±0.25（t=6.07，p＜0.01）、1.13±0.24和0.87±0.38（t=3.36，p＜0.01）、1.18±0.30和0.92±0.36（t=3.49，p＜0.01）、1.20±0.28和1.01±0.31（t=2.73，p＜0.01）。动脉期灰阶比值的曲线下面积为0.863，阈值为0.93，敏感度88.9%，特异度69.7%；实质期灰阶比值的曲线下面积0.794，阈值为1.04，敏感度75.6%，特异度75.8%；静脉期曲线下面积0.754，阈值1.00，敏感度64.4%，特异度84.8%；延迟期灰阶比值曲线下面积为0.678，阈值为1.10，敏感度57.8%，特异度72.7%；联合诊断模型的准确度为79.5%，曲线下面积0.862，敏感性88.9%，特异性72.7%。结论 MRI灰阶比值可量化瘤体强化差异，在鉴别诊断G2、G3级PNET和PDAC中有较高的临床意义。 |
| 英文摘要: |
| Objective To explore the value of gray scale ratio of MRI in differential diagnosis of G2、G3 grade pancreatic neuroendocrine tumors (PNET) and pancreatic cancer (PDAC).Methods The MRI enhancement data of 37 cases of G2、G3 grade PNET and 52 cases of PDAC confirmed by cases were analyzed retrospectively. Through the gray-scale value measurement software of film reading system, the gray-scale values of lesions in each stage of enhancement and normal pancreas at the same level were measured, and the gray-scale ratio between lesions and normal pancreas was calculated. The values of the two groups were analyzed by t-test, the threshold of the best ratio was obtained by ROC curve，and establish a joint prediction model. Results The values of lesions and normal pancreas in T1 flat scanning,arterial phase, parenchymal phase, venous phase and delayed phase of 37 cases of PNET and 52 cases of PDAC were0.76±0.17and0.81±0.26（t=-0.91, P =0.36）,1.03 ± 0.30 and 0.65 ± 0.25 (t = 6.07, P < 0.01), 1.13 ± 0.24 and 0.87 ± 0.38 (t = 3.36, P < 0.01), 1.18 ± 0.30 and 0.92 ± 0.36 (t = 3.49, P < 0.01), 1.20 ± 0.28 and 1.01 ± 0.31 (t = 2.73, P < 0.01). The area under the curve of gray scale ratio in arterial phase was 0.863, the threshold was 0.93, the sensitivity was 88.9%, and the specificity was 69.7%; the area under the curve of gray scale ratio in parenchymal stage was 0.794, the threshold was 1.04, the sensitivity was 75.6%, and the specificity was 75.8%; the area under the venous phase curve was 0.754, the threshold was 1.00, the sensitivity was 64.4%, and the specificity was 84.8%; the area under the gray scale ratio curve in the delayed period was 0.678, the threshold was 1.10, the sensitivity was 57.8%, and the specificity was 72.7%；the accuracy of the combined prediction model was 79.5%, the area under the curve was 0.862, the sensitivity was 88.9%, and the specificity was 72.7%. Conclusion MRI gray scale ratio finely quantified the difference of tumor enhancement. It has a high clinical significance in differential diagnosis of PNET and PDAC. |
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