Abstract：
OBJECTIVE: This study aimed to assess the computed tomography (CT) and magnetic resonance imaging (MRI) features of pancreatic mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) and compare them with those of pancreatic ductal adenocarcinoma (PDAC) and neuroendocrine tumor (NET).
METHODS: Twelve patients with pancreatic MiNEN, 24 patients with PDAC, and 24 patients with NET, who underwent both contrast-enhanced CT and MRI, were included. Clinical data and the key imaging features were retrospectively evaluated by two independent readers and compared between MiNEN and PDAC or NET. Univariate and multivariable logistic regression analyses were performed to obtain predictors for pancreatic MiNEN.
RESULTS: Patients with pancreatic MiNEN more frequently presented with large size and heterogeneous and cystic components compared with PDAC (p < 0.031) and ill-defined irregular margins, progressive enhancement, and adjacent organ involvement compared with NET (p < 0.036). However, vascular invasion was less commonly seen in MiNEN than PDAC (p = 0.010). Moderate enhancement was observed more frequently in MiNEN than in PDAC or NET (p < 0.001). Multivariate logistic analyses demonstrated that moderate enhancement and ill-defined irregular margin were the most valuable features for the prediction of pancreatic MiNEN (p ≤ 0.044). The combination of the two features resulted in a specificity of 93.8%, sensitivity of 83.3%, and accuracy of 91.7%.
CONCLUSIONS: We have mainly described the radiological findings of pancreatic MiNEN with ill-defined irregular margin and moderate enhancement compared with PDAC and NET. The combination of imaging features could improve diagnostic efficiency and help in the selection of the correct treatment method.
METHODS: Twelve patients with pancreatic MiNEN, 24 patients with PDAC, and 24 patients with NET, who underwent both contrast-enhanced CT and MRI, were included. Clinical data and the key imaging features were retrospectively evaluated by two independent readers and compared between MiNEN and PDAC or NET. Univariate and multivariable logistic regression analyses were performed to obtain predictors for pancreatic MiNEN.
RESULTS: Patients with pancreatic MiNEN more frequently presented with large size and heterogeneous and cystic components compared with PDAC (p < 0.031) and ill-defined irregular margins, progressive enhancement, and adjacent organ involvement compared with NET (p < 0.036). However, vascular invasion was less commonly seen in MiNEN than PDAC (p = 0.010). Moderate enhancement was observed more frequently in MiNEN than in PDAC or NET (p < 0.001). Multivariate logistic analyses demonstrated that moderate enhancement and ill-defined irregular margin were the most valuable features for the prediction of pancreatic MiNEN (p ≤ 0.044). The combination of the two features resulted in a specificity of 93.8%, sensitivity of 83.3%, and accuracy of 91.7%.
CONCLUSIONS: We have mainly described the radiological findings of pancreatic MiNEN with ill-defined irregular margin and moderate enhancement compared with PDAC and NET. The combination of imaging features could improve diagnostic efficiency and help in the selection of the correct treatment method.
摘要：
目的：本研究旨在评估胰腺神经内分泌-非神经内分泌混合性肿瘤（MiNEN）的计算机断层扫描（CT）和磁共振成像（MRI）特征，并与胰腺导管腺癌（PDAC）和神经内分泌肿瘤（NET）进行比较。
方法：12例胰腺MiNEN患者，24例PDAC患者，和24名NET患者，同时接受了对比增强CT和MRI检查，包括在内。由两名独立的读者回顾性评估临床数据和关键影像学特征，并在MiNEN和PDAC或NET之间进行比较。进行单变量和多变量逻辑回归分析以获得胰腺MiNEN的预测因子。
结果：与PDAC（p<0.031）相比，胰腺MiNEN患者更常表现为大体积，异质性和囊性成分，边缘不明确，渐进增强,与邻近器官受累NET比拟(p<0.036)。然而,与PDAC相比,MiNEN中血管侵犯较不常见(p=0.010).在MiNEN中比在PDAC或NET中更频繁地观察到中度增强(p<0.001)。多变量分析表明，中度增强和不明确的不规则边缘是预测胰腺MiNEN的最有价值的特征（p≤0.044）。这两个特征的结合导致了93.8%的特异性,灵敏度83.3%,精度达91.7%。
结论：与PDAC和NET相比，我们主要描述了胰腺MiNEN的放射学发现，其边缘不明确，不规则，增强程度中等。影像特征的组合可以提高诊断效率并有助于选择正确的治疗方法。
方法：12例胰腺MiNEN患者，24例PDAC患者，和24名NET患者，同时接受了对比增强CT和MRI检查，包括在内。由两名独立的读者回顾性评估临床数据和关键影像学特征，并在MiNEN和PDAC或NET之间进行比较。进行单变量和多变量逻辑回归分析以获得胰腺MiNEN的预测因子。
结果：与PDAC（p<0.031）相比，胰腺MiNEN患者更常表现为大体积，异质性和囊性成分，边缘不明确，渐进增强,与邻近器官受累NET比拟(p<0.036)。然而,与PDAC相比,MiNEN中血管侵犯较不常见(p=0.010).在MiNEN中比在PDAC或NET中更频繁地观察到中度增强(p<0.001)。多变量分析表明，中度增强和不明确的不规则边缘是预测胰腺MiNEN的最有价值的特征（p≤0.044）。这两个特征的结合导致了93.8%的特异性,灵敏度83.3%,精度达91.7%。
结论：与PDAC和NET相比，我们主要描述了胰腺MiNEN的放射学发现，其边缘不明确，不规则，增强程度中等。影像特征的组合可以提高诊断效率并有助于选择正确的治疗方法。
