Background: Magnetic Resonance Imaging (MRI) is a useful imaging modality to assess the presence of Pancreatic Neuroendocrine Tumors (PNETs), allowing repeat monitoring examinations in MEN-1 patients. Objectives: We aimed to compare the diagnostic accuracy of conventional MRI sequences identifying which better depict the presence of PNETs in MEN-1 patients. Method: We performed a retrospective analysis of consecutive MEN-1 patients who underwent a conventional MRI protocol to monitor previously proven PNETs. MRI sequences T1-w Chemical-Shift (CS), T2-w HASTE, fat-suppressed (FS) T2-w HASTE, Diffusion Weighted Imaging (DWI), pre- and post-contrast FS T1-w sequences were independently analyzed by two experienced radiologists using a three-grade score (no lesion, uncertain lesion, certain lesion); lesion size and signal intensity were recorded. ANOVA Friedman and a Wilcoxon pairwise tests for the post-hoc analysis were used. The sensitivity of each sequence was measured; the results were analyzed with the Chi-squared test. Results: We included 21 patients with a total of 45 PNETs proven by histology, EUS guided fine needle aspiration, CT and nuclear medicine studies. A statistically significant (p<0.01) difference was observed in the detection performance of each MRI sequence, particularly between both DWI (91%) and T2-w FS (85%) sequences in comparison to the others (T1-w CS, T2-w, pre- and post-contrast FS T1-w, ≤56% for all); no significant (p=0.5) difference was found between the detection performance of DWI and T2-w FS sequences. No correlation was observed between the qualitative score of each sequence and lesion tumor size. Conclusions: DWI and T2-w FS sequences proved to be the most accurate in the detection of PNETs, thus suggesting a role for an abbreviated MRI protocol without contrast medium administration for monitoring MEN-1 patients.


中文翻译：

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多发性内分泌肿瘤1型患者的胰腺神经内分泌肿瘤：不同MRI序列的诊断价值。

背景：磁共振成像 (MRI) 是评估胰腺神经内分泌肿瘤 (PNET) 存在的一种有用的成像方式，允许对 MEN-1 患者进行重复监测检查。目的：我们旨在比较传统 MRI 序列的诊断准确性，以确定哪些更好地描述了 MEN-1 患者中 PNET 的存在。方法：我们对接受常规 MRI 方案监测先前证实的 PNET 的连续 MEN-1 患者进行了回顾性分析。MRI 序列 T1-w 化学位移 (CS)、T2-w HASTE、脂肪抑制 (FS) T2-w HASTE、扩散加权成像 (DWI)、对比前和对比后 FS T1-w 序列通过以下方法独立分析两名经验丰富的放射科医生使用三级评分（无病变、不确定病变、确定病变）；记录病变大小和信号强度。使用 ANOVA Friedman 和 Wilcoxon 成对检验进行事后分析。测量每个序列的灵敏度；用卡方检验分析结果。结果：我们纳入了 21 名患者，共有 45 个 PNET，经组织学、EUS 引导的细针抽吸、CT 和核医学研究证实。在每个 MRI 序列的检测性能中观察到统计学上显着的 (p<0.01) 差异，特别是在 DWI (91%) 和 T2-w FS (85%) 序列之间与其他序列 (T1-w CS, T2 -w，对比前后 FS T1-w，≤56%）；DWI和T2-w FS序列的检测性能没有显着差异（p=0.5）。在每个序列的定性评分和病变肿瘤大小之间没有观察到相关性。结论：