To Discuss Diagnosis Value Of MSCT And MRI Of Pancreatic Neuroendocrine Tumors And Quantitative Analysis Dual-source CT Perfusion

Objective 1.To compare and analysis multi-slice computed tomography and magnetic resonance imaging,discuss diagnosis value respectively.2.Quantitative analysis diagnosis value of dual-source CT perfusion imaging on pancreatic neuroendocrine tumors.Methods 1.Retrospectively analysis clinical manifestations 、 CT and MRI imaging of sixty-four(sixty-eight tumours)patients with pancreatic neuroendocrine tumors which were proved by surgery pathology or needle biopsy,analysis the causes of missed/misdiagnose of nontypical pancreatic neuroendocrine tumors.2.Dual-source CT perfusion imaging was done in patients who were clinically suspected with pancreatic neuroendocrine tumors,quantitative analysis the perfusion parameters(BF、BV、PS、MTT、TTP 及 TTS)of twenty(twenty-six tumors)patients which were proved by surgery pathology or needle biopsy,Statisticalanalysis differences between tumor and non-tumor area,draw TDC curves and analysis the diagnosis value of perfusion parameters.Results 1、 Among sixty-four patients,fifty-six cases(sixty tumors)underwent MSCT plain scan and triple-phase enhanced scan,there were six missing diagnoses,the sensitivity was 90%(54/60)。On MSCT plain scan,twenty-seven lesions showed uniform isodensity,another twenty-seven lesions showed mixed high and low / slightly low density,five lesions with scattered dots,lines or nodular calcification.Enhanced scan showed that twenty-five lesions were hypervascular and uniform enhancement,twenty lesions were hypervascular and inhomogeneous enhancement,nine lesions were hypovascular,seven lesions showed necrotic,eight lesions showed fuzzy boundaries,local infiltration,involving the space of surrounding fat,blood vessels and nerve tissue;eight lesions appear –ed liver metastasis,in which one involving the gallbladder and bile ducts,two with retropeperitoneal metastasis;two leisions showed dilated pancreatic duct,one showed dilated intrahepatic and extrahepatic bile duct,a liver bile duct dilatation,two lesions with retention cyst formation.Thirty-three cases(thirty-seven tumors)underwent MRI plain scan and triple-phase enhanced scan,there were four missing diagnoses,the sensitivity was 89.2%(33/37).On MRI plain scan,Thirty-three lesions showed slightly long/long T1 signal,two lesions showed short T2 signal,one lesion showed isointensity signal,the others showed slightly long/long T2 signal,On enhanced MRI,the enhancement pattern and extent consistent with MDCT.Twenty-five cases underwent MSCT and MRI..It was showed that there were 36 G1,24 G2 and 8G3.Statistical analysis showed that there was no significant difference among G1,G2 and G3 in terms of sex and age(P>0.05);there was no significant difference between G1 and G2 for diameter(P>0.05),the diameter of G1 and G2 was significantly less than G3,there was a statistically difference(P<0.05).2、 Statistical analysis BF,BV,PS,MTT,TTP,TTS between twenty-six lesions and adjacent normal pancreatic tissue,the results show that there is a statistically significant difference between two groups of BF,BV,MTT and TTP and there is nosignificant difference for PS and TTS.Analysis ROC curves of perfusion parameters,the area under the curve of BF,BV and PS are respectively 0.883,0.886,0.752 and all higher than 0.5;the area under the curve of MTT,TTP and TTS are all smaller than 0.5.Conclusion 1、Conventional MSCT or MRI plain scan and multi-phase enhanced scan have a high diagnostic value for typical pancreatic neuroendocrine tumors,MSCT combined MRI can improve detection rate of atypical pancreatic neuroendocrine tumor.2、CT perfusion imaging can not only provide morphological information of tisseus and lesions which multi-phase enhanced CT can observe,but also dynamic observe inflow and outflow process of the contrast,precise knowledge the enhancement way and degree of lesions.It can also prevent missed,such as,small lesions or the improper phase,in addition,CT perfusion imaging can quantitatively analyses the perfusion parameters of the tissues and lesions,and get a deeper understanding of the vascular distribution,blood supply and vascular permeability,which may provide a quantitative information.At the same time,it can guide the clinical and formulate the opitimal scanning of p NETs.