目的:胰腺浆液性囊腺瘤(SCAs)和黏液性囊腺瘤(MCAs)的生物学行为完全不同,术前诊断具有重要意义。我们研究的目的是检查和比较SCA和MCA的详细对比增强超声(CEUS)图像,并确定是否有重要发现有助于区分这两种疾病。
方法:从2015年4月至2016年6月,本研究纳入了61例患者(SCA患者35例,MCA患者26例)。经手术病理证实43例,经临床综合诊断18例。记录这些病变的所有CEUS特征:大小,location,回声,形状,墙的特点,隔片特点,以及蜂窝状图案或结节的存在。CEUS检查由两名超声医师进行。
结果:位置(P=0.003),形状(P=0.000),壁厚(P=0.005),隔膜的数量(P=0.001),蜂巢模式(P=0.001)差异有统计学意义。头颈位置,分叶状,内部规则的蜂窝图案,薄壁(<3mm厚)在诊断SCAs患者中具有重要意义。当这四个发现中的两个结合起来,我们可以达到71.4%的灵敏度和80.8%的特异性诊断SCA;当这四个发现中的三个结合起来,特异性为100%.身体-尾巴位置,圆形/椭圆形,0-2隔片,在MCAs患者中最常见的是厚壁(≥3mm厚)。当这四个发现中的两个结合起来,我们可以达到88.5%的灵敏度和65.7%的特异性来诊断MCA;当这四个发现中的三个结合起来,曲线下面积(Az)最高,为0.832,敏感性为80.8%,特异性为85.7%.
结论:肿瘤位置的特点,形状,墙的厚度,隔片的数量,CEUS的蜂窝模式在SCA和MCA的诊断中起着重要作用。这些发现的组合可以在区分SCA和MCA方面提供更好的诊断性能。
OBJECTIVE: The preoperative diagnosis between serous cystadenomas (SCAs) and mucinous cystadenomas (MCAs) in pancreas is significant due to their completely different biological behaviors. The purpose of our study was to examine and compare detailed contrast-enhanced ultrasonography (CEUS) images of SCAs and MCAs and to determine whether there are significant findings that can contribute to the discrimination between these two diseases.
METHODS: From April 2015 to June 2016, 61 patients (35 patients with SCAs and 26 patients with MCAs) were enrolled in this study. Forty-three cases were confirmed by surgical pathology and 18 by comprehensive clinical diagnoses. All of the CEUS characteristics of these lesions were recorded: size, location, echogenicity, shape, wall characteristics, septa characteristics, and the presence of a honeycomb pattern or nodules. CEUS examinations were performed by two ultrasound physicians.
RESULTS: Location (P=0.003), shape (P=0.000), thickness of the wall (P=0.005), the number of septa (P=0.001), and the honeycomb pattern (P=0.001) were statistically significantly different. A head-neck location, a lobulated shape, an inner regular honeycomb pattern, and a thin wall (<3 mm thick) were significant in diagnosing patients with SCAs. When two of these four findings were combined, we could achieve a sensitivity of 71.4% and a specificity of 80.8% to diagnose SCA; when three of these four findings were combined, the specificity was 100%. A body-tail location, a round/oval shape, 0-2 septa, and a thick wall (≥3 mm thick) were most often detected in patients with MCAs. When two of these four findings were combined, we could achieve a sensitivity of 88.5% and a specificity of 65.7% to diagnose MCA; when three of these four findings were combined, the area under the curve (Az) was highest at 0.832, with a sensitivity of 80.8% and a specificity of 85.7%.
CONCLUSIONS: The characteristics of tumor location, shape, thickness of the wall, the number of septa, and the honeycomb pattern by CEUS play an important role in the diagnosis of SCAs and MCAs. A combination of these findings can provide better diagnostic performance in the discrimination of SCAs from MCAs.