最初发现胰腺囊性病变患者的影像学监测

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-04-06 DOI:10.1016/j.ejrad.2025.112102

Hyo Jung Park , Sehee Kim , Sang Hyun Choi , Jin Hee Kim , Seung Soo Lee , Hyoung Jung Kim , Jae Ho Byun

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引用次数: 0

摘要

目的确定接受监测的胰腺囊性病变（PCL）的长期预后，并评估成像监测计划与发现恶性进展之间的关联。方法这项回顾性观察研究纳入了 2015 年 1 月至 2016 年 12 月间在 MRI 上偶然发现 PCL（0.5-4.0 厘米）的患者。研究记录了成像方式、时间间隔、累计成像检查次数以及恶性进展的发生情况。结果共有911名患者（平均年龄68.8岁；445名导管内乳头状黏液瘤[IPMN]患者）在随访期间平均接受了5次检查（中位数为45.0个月）。所有20例恶性进展病例均发生在IPMN患者身上，在最长9年的随访期间，恶性进展病例稳步增加。核磁共振成像检查的累计次数与1年（危险比 [HR] = 1.40；P = 0.035）和2年（HR = 1.38；P = 0.047）标志点恶性进展的发现显著相关，而CT检查则无此关联。在350例无令人担忧特征的IPMN患者中，MRI检查的累计次数与1年（HR = 1.63；P = 0.007）和2年（HR = 1.59；P = 0.013）标志点的恶性进展相关，但在95例有令人担忧特征的IPMN患者中，MRI检查的累计次数与恶性进展无关。基于磁共振成像的监测在最初的两年内是有益的，尤其是对于没有令人担忧特征的 IPMN 患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Imaging-based surveillance in patients with initially detected pancreatic cystic lesions

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Imaging-based surveillance in patients with initially detected pancreatic cystic lesions

Purpose

To determine the long-term outcomes of pancreatic cystic lesions (PCLs) undergoing surveillance, and evaluate the associations between imaging monitoring plans and detection of malignant progression.

Methods

This retrospective observational study included patients with incidentally detected PCLs (0.5–4.0 cm) on MRI between January 2015 and December 2016. Imaging modalities, time intervals, cumulative number of imaging examinations, and occurrence of malignant progression were recorded. The impact of cumulative CT/MRI examinations on detection of malignant progression at 1, 2, and 3-years was assessed using Cox-regression analyses.

Results

A total of 911 patients (mean age, 68.8-years; 445 with intraductal papillary mucinous neoplasm [IPMN]) underwent an average of five examinations during follow-up (median, 45.0-months). All 20 cases of malignant progression occurred in patients with IPMN, increasing steadily over the maximum 9-year follow-up. The cumulative number of MRI examinations was significantly associated with detection of malignant progression at 1-year (hazard ratio [HR] = 1.40; P = 0.035), and 2-year (HR = 1.38; P = 0.047) landmark points, while CT showed no such association. The cumulative number of MRI examinations was associated with malignant progression at both 1-year (HR = 1.63; P = 0.007) and 2-year (HR = 1.59; P = 0.013) landmark points in 350 patients with IPMN without worrisome features, but not in 95 patients with IPMN with worrisome features.

Conclusion

Imaging surveillance of incidentally detected PCLs for detecting malignant progression should prioritize IPMNs. MRI-based surveillance would be beneficial in the initial 2-years, especially for patients with IPMN lacking worrisome features.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.