为了开发和验证基于成像的模型来预测导管内乳头状粘液性肿瘤 (IPMN) 的恶性肿瘤风险。我们回顾性分析了 241 名术前接受 CT 和 MRI 的 IPMN 患者的数据，以进行模型开发。评估囊肿大小、增强壁结节 (EMN) 的存在和大小、主胰管 (MPD) 直径、囊壁增厚/增强、MPD 口径突然变化伴远端萎缩以及淋巴结肿大。使用这些成像特征，使用连续变量（模型 C）或二分变量（模型 D）创建预测恶性肿瘤风险的多重逻辑回归模型。验证包括内部 (n = 55) 和外部 (n = 43) 数据集。使用受试者工作特征曲线 (AUC) 下面积评估模型性能，并与基于国际指南的模型（模型 F）进行比较。模型 C 将年龄、EMN 大小、MPD 直径和淋巴结病确定为 CT 的独立预测因子，以及年龄以及 MRI 上 EMN 的存在和大小。 D模型将年龄≥68岁、囊肿大小≥31mm、EMN≥6mm、MPD≥7mm和淋巴结肿大作为CT的独立预测因素，年龄≥68岁、EMN≥4.5mm和MRI上的淋巴结肿大作为独立预测因素。模型C（AUC，0.763-0.899）表现略好于模型D（AUC，0.753-0.912），但无统计学意义。模型 C 和 F 之间没有观察到显着差异（AUC，0.729-0.952）。将模型 C 与梗阻性黄疸相结合可改善表现（AUC，0.802-0.941），但无统计学意义。我们的基于影像学的模型有效预测了 IPMNs 的恶性风险，与国际共识指南相当。影像学特征对于预测 IPMNs 的恶性潜力非常重要。我们的基于成像的模型可能有助于确定 IPMN 患者的手术候选资格。非侵入性确定导管内乳头状粘液性肿瘤 (IPMN) 的恶性潜力可以做出适当的治疗决策。我们确定了与恶性转化相关的多种影像学特征，并开发了这些特征此预测的模型。我们的模型在预测 IPMN 的恶性潜力方面与国际共识指南相当。© 2024。作者获得欧洲放射学会的独家许可。

To develop and validate imaging-based models for predicting the malignancy risk of intraductal papillary mucinous neoplasm (IPMN).We retrospectively analyzed data from 241 IPMN patients who underwent preoperative CT and MRI for model development. Cyst size, presence and size of the enhancing mural nodule (EMN), main pancreatic duct (MPD) diameter, thickened/enhancing cyst wall, abrupt MPD caliber change with distal atrophy, and lymphadenopathy were assessed. Multiple logistic regression models predicting malignancy risk were created using either continuous (Model C) or dichotomized variables (Model D) using these imaging features. Validation included internal (n = 55) and external (n = 43) datasets. Model performance was assessed using the area under the receiver operating characteristic curve (AUC) and compared with that of the international guideline-based model (Model F).Model C identified age, EMN size, MPD diameter, and lymphadenopathy as independent predictors on CT, and age and presence and size of EMN on MRI. Model D identified age ≥ 68, cyst size ≥ 31 mm, EMN ≥ 6 mm, MPD ≥ 7 mm, and lymphadenopathy as independent predictors on CT, and age ≥ 68, EMN ≥ 4.5 mm, and lymphadenopathy on MRI. Model C (AUC, 0.763-0.899) performed slightly better than Model D (AUC, 0.753-0.912) without statistical significance. No significant difference was observed between Models C and F (AUC, 0.729-0.952). Combining Model C with obstructive jaundice improved performance (AUC, 0.802-0.941) without statistical significance.Our imaging-based models effectively predicted the malignancy risk of IPMNs, comparable to international consensus guidelines.Imaging features are important for predicting the malignant potential of IPMNs. Our imaging-based model may help determine surgical candidacy for patients with IPMNs.Non-invasively determining the malignant potential of intraductal papillary mucinous neoplasms (IPMNs) allows for appropriate treatment decision-making We identified multiple imaging features that are associated with malignant transformation and developed models for this prediction. Our model performs comparably with international consensus guidelines in predicting the malignant potential of IPMNs.© 2024. The Author(s), under exclusive licence to European Society of Radiology.