Hypervascular solid-appearing serous cystic neoplasms of the pancreas: Differential diagnosis with neuroendocrine tumours
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To describe imaging findings of arterial hypervascular solid-appearing serous cystic neoplasms (SCNs) of the pancreas on CT and MR and determine imaging features differentiating them from neuroendocrine tumours (NETs).
Materials and methods
We retrospectively identified 15 arterial hypervascular solid-appearing SCNs and randomly chose 30 size-matched pancreatic NETs. On CT, two radiologists in consensus assessed the size, morphology, and CT attenuation. On MR, predominant signal intensity and the amount of the cystic component on T2-weighted images and ADC maps were evaluated and compared using Fisher’s exact and Student’s t-test.
The mean SCN size was 2.6 cm (range, 0.8–8.3). The CT findings were similar between the two tumours: location, shape, margin, and enhancement pattern. SCNs were significantly more hypodense on non-enhanced CT images than NETs (P = .03). They differed significantly on MR: bright signal intensity (P = .01) and more than a 10 % cystic component on T2-weighted images (P = .01) were more common in SCNs than in NETs. All SCNs showed a non-restrictive pattern on the ADC map, while NETs showed diffusion restriction (P < .01).
Arterial hypervascular solid-appearing SCNs and NETs share similar imaging features. Non-enhanced CT and MR images with T2-weighted images and ADC maps can facilitate the differentiation.
• Frequency of hypervascular solid-appearing SCNs was 7.3 % among surgically confirmed SCNs.
• Hypervascular solid-appearing SCN of the pancreas can mimic pancreatic NETs.
• Unenhanced CT and MR features help to differentiate the two tumours.
KeywordsPancreatic neoplasms Diagnosis Diagnostic imaging Multidetector computed tomography Magnetic resonance imaging
Abbreviations and acronyms
Apparent diffusion coefficient
Serous cystic neoplasms
The scientific guarantor of this publication is Moon-Gyu Lee. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding from Grant #2012R1A1A1012731 to the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology, Korea. The authors have no financial association that may pose a conflict of interests with the submitted manuscript. Seong Ho Park (one of the authors) has significant statistical expertise. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. None of our study subjects have been previously reported.
Methodology: retrospective, diagnostic or prognostic study, performed at one institution.
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