- 作者：Renata Brenner ; epmrenata@gmail.com ; Thierry Metens tmetens@ulb.ac.be ; Maria Bali mbali@ulb.ac.be ; Pieter Demetter pieter.demetter@erasme.ulb.ac.be ; Celso Matos cmatos@ulb.ac.be
- 关键词：Pancreas ; Neuroendocrine tumors ; Diffusion-weighted imaging ; MRI
- 刊名：European Journal of Radiology
- 出版年：2012
- 期刊代码：93_0720048x
- 类别：med
- 出版时间：May, 2012
- 卷：81
- 期：5
- 页码：e746-e749
- 文件大小：293 K
Objectives
To investigate the added value of fusion of high b-value diffusion-weighted images (DWI) and T2-weighted (T2) MR images for the detection of pancreatic neuroendocrine tumors (PNT).Methods
18 patients with 18 histologically proven PNT were included. Two radiologists independently and retrospectively reviewed four randomized images sets (T2+T1, DWI, T2+DWI, and DWI+T2 fusion). Lesion detection confidence level was assessed using a three grade score (no lesion; uncertain lesion and certain lesion); lesion size and signal intensity were recorded. Apparent diffusion coefficients (ADC) of tumor and adjacent pancreas were measured.
Results
Readers 1 and 2 respectively detected 14/18 and 16/18 lesions on T2+T1, 13/18 and 12/18 on DWI, 16/18 and 15/18 on T2+DWI and 17/18 and 16/18 on DWI+T2 fusion. Lesion median size was 16 mm (range: 7 mm-40 mm), 22%were hyperfunctioning (all insulinomas) and 72%were low-grade (Rindi 1). All tumors except one (with cystic component) showed lower ADC than adjacent pancreatic parenchyma. Fusion imaging had significantly better detection score by both authors (p < 0.005) and provided the higher inter-reader agreement (kappa 0.7). DWI alone had the worst score for both readers.
Conclusions
Fusion images improve the detection of PNT, especially in patients with small isointense lesions on conventional MR sequences.