磁共振成像2025，Vol.16Issue(5)：8-13,6.DOI:10.12015/issn.1674-8034.2025.05.002
平扫MRI对胰腺导管内乳头状黏液性肿瘤良恶性壁结节的诊断价值
Diagnostic value of non-contrast MRI in evaluating benign and malignant mural nodules of intraductal papillary mucinous neoplasms of the pancreas
摘要
Abstract
Objective:To explore the diagnostic value of non-contrast MRI in evaluating benign and malignant mural nodules of intraductal papillary mucinous neoplasms(IPMN)of the pancreas.Materials and Methods:Patients with pancreatic IPMN who were pathologically diagnosed after radical surgical resection in the First Affiliated Hospital of Naval Medical University from August 2013 to February 2024 were collected.A total of 238 patients with IPMN containing mural nodules were screened out through non-contrast MRI.According to the pathological grading criteria of IPMN,the patients were divided into the benign mural nodule group(low-grade dysplasia)and the malignant mural nodule group(high-grade dysplasia,invasive carcinoma).Independent sample t-test,rank sum test and chi-square test were used for statistical analysis to compare the differences in non-contrast MRI features between the two groups.Multivariate logistic regression was used to analyze the independent predictors of the malignant mural nodule group of pancreatic IPMN,and a diagnostic model was constructed.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated.Results:The diameter of mural nodules in the malignant mural nodule group[15.00(10.00,23.00)mm]was larger than that in the benign mural nodule group[7.00(6.00,9.75)mm],and the difference was statistically significant(P＜0.001).In the malignant mural nodule group,the manifestations such as main pancreatic duct or mixed pancreatic duct type,high signal of cystic fluid on T1WI,main pancreatic duct dilation ≥ 10 mm,cysts ≥ 40 mm,thickening of the cyst wall,and abrupt change in caliber of pancreatic duct with distal pancreatic atrophy.There were statistically significant differences when compared with the benign group of mural nodules(all P＜0.05).The results of multivariate logistic regression analysis showed that the threshold diameter of mural nodules of 9.5 mm,thickening of the cyst wall,and abrupt change in caliber of pancreatic duct with distal pancreatic atrophy were independent predictors for the malignant mural nodule group(all P＜0.05).A model was established by combining these three independent predictors to diagnose the malignant mural nodule group,and the AUC was 0.851[95％confidence interval(CI):0.802 to 0.900],with a sensitivity of 70.7％and a specificity of 90.5％.Conclusions:The threshold diameter of mural nodules of 9.5 mm,thickening of the cyst wall,and abrupt change in caliber of pancreatic duct with distal pancreatic atrophy are independent predictors for evaluating malignant mural nodules of pancreatic IPMN based on the features of non-contrast MRI.The diagnostic model combining these three factors shows good diagnostic efficacy.关键词
胰腺/导管内乳头状黏液性肿瘤/壁结节/磁共振成像Key words
pancreas/intraductal papillary mucinous neoplasm/mural nodule/magnetic resonance imaging分类
医药卫生引用本文复制引用
方旭,边云,陆建平..平扫MRI对胰腺导管内乳头状黏液性肿瘤良恶性壁结节的诊断价值[J].磁共振成像,2025,16(5):8-13,6.基金项目
Nature National Science Foundation of China(No.82171915,82171930,82371955) （No.82171915,82171930,82371955）
Shanghai Health Commission Health Industry Clinical Research Project(No.20234Y0296). 国家自然科学基金项目(编号:82171915、82171930、82371955) （No.20234Y0296）
上海市卫生健康委员会卫生行业临床研究专项(编号:20234Y0296) （编号:20234Y0296）
