Comparison between solid pseudopapillary neoplasms of the pancreas and pancreatic ductal adenocarcinoma with cystic changes using computed tomography

作者：Shuai Ren, Li-Chao Qian, Xiaojing Lv, Yingying Cao, Marcus J. Daniels, Zhongqiu Wang, Lina Song, Ying Tian · 发表于：World Journal of Radiology · 年份：2024 · DOI：10.4329/wjr.v16.i6.211 · 被引用次数：9 · 研究领域：Pancreatic and Hepatic Oncology Research、Pancreatitis Pathology and Treatment、Gallbladder and Bile Duct Disorders

BACKGROUND Solid pseudopapillary neoplasms of the pancreas (SPN) share similar imaging findings with pancreatic ductal adenocarcinoma with cystic changes (PDAC with cystic changes), which may result in unnecessary surgery. AIM To investigate the value of computed tomography (CT) in differentiation of SPN from PDAC with cystic changes. METHODS This study retrospectively analyzed the clinical and imaging findings of 32 patients diagnosed with SPN and 14 patients diagnosed with PDAC exhibiting cystic changes, confirmed through pathological diagnosis. Quantitative and qualitative analysis was performed, including assessment of age, sex, tumor size, shape, margin, density, enhancement pattern, CT values of tumors, CT contrast enhancement ratios, “floating cloud sign,” calcification, main pancreatic duct dilatation, pancreatic atrophy, and peripancreatic invasion or distal metastasis. Multivariate logistic regression analysis was used to identify relevant features to differentiate between SPN and PDAC with cystic changes, and receiver operating characteristic curves were obtained to evaluate the diagnostic performance of each variable and their combination. RESULTS When compared to PDAC with cystic changes, SPN had a lower age (32 years vs 64 years, P < 0.05) and a slightly larger size (5.41 cm vs 3.90 cm, P < 0.05). SPN had a higher frequency of “floating cloud sign” and peripancreatic invasion or distal metastasis than PDAC with cystic changes (both P < 0.05). No signifi...