Multiple solid pancreatic lesions: Prevalence and features of non-malignancies on dynamic enhanced CT

作者：Zhu, Liang; Dai, Meng-hua; Wang, Shi-tian; Jin, Zheng-yu^*; Wang, Qiang; Denecke, Timm; Hamm, Bernd; Xue, Hua-dan

来源：European Journal of Radiology, 2018, 105: 8-14.

DOI：10.1016/j.ejrad.2018.05.016

• Computed tomography
• Pancreatic cancer
• Pancreatitis
• Neuroendocrine tumours
• Metastasis

Objective: To determine the prevalence of multiple solid pancreatic lesions on dynamic enhanced CT performed for suspected pancreatic diseases, and to identify CT features of non-malignancies.
Methods: We investigated 8096 consecutive patients who underwent dynamic enhanced CT pancreas protocol at a tertiary center over 40 months. The final clinical /pathological diagnosis served as reference standard. The diagnostic accuracy of dynamic enhanced CT for non-malignancies was calculated. A univariate and multivariate analysis was conducted to identify features that predict non-malignancies.
Results: Multiple solid pancreatic lesions were identified in 121 patients. The prevalence of non-malignancies was 19.8% (24/121). The most common non-malignancy was autoimmune pancreatitis (n = 21; 17.4%). Common lesions with malignant potential included neuroendocrine neoplasia (n = 62; 51.2%), ductal adenocarcinoma (n = 15; 12.4%), metastasis (n = 9; 7.4%), and lymphoma (n = 7; 5.8%). Dynamic enhanced CT had a sensitivity of 79.2% and a specificity of 92.8% for diagnosing non-malignancies. Elevated serum IgG4 level (p < 0.001), hypo-enhancement in arterial phase (p = 0.001), hyper-enhancement in equilibrium phase (p = 0.009) and location in both proximal and distal pancreas (p = 0.036) were predictors of non-malignancies, whereas pancreatic duct morphology and vascular invasion status were not.
Conclusion: Multiple solid pancreatic lesions were rare, with a wide spectrum. Dynamic enhanced CT provides clues for identifying non-malignancies.

• 出版日期2018-8
• 单位中国医学科学院北京协和医院