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Objective To investigate the correlation between the contrast-enhanced image features of pancreatic neuroendocrine tumors(PNETs)and the pathological tumor grades according to the recent WHO classification.Materials and methods We queried the endocrinology departments databases of our hospital to identify all pathologically proven PNETs cases during a period from 2012 to 2015.All patients underwent preoperative dynamic-enhanced CT or MRI examinations to evaluate pancreatic tumors.The remaining 24 patients(10 men and 14 women; median age,59 years; range,27–70 years)were included in the present study.Eight patients had neuroendocrine tumor grade-1(NET-G1).Thirteen patients with NET-G2,two patients with NET-G3 and one patient with neuroendocrine cancer grade-3(NEC-G3).The image features were evaluated by a radiologist(with 8 years of experience in radiology).The tumor conspicuity during each phase was visually rated as either hyperattenuation or non-hyperattenuation comparing with the pancreas parenchyma.We divided all patients into two groups.Group A included the patients with NET-G1,and group B included the patients with NET-G2,NET-G3 and NEC-G3.Chi-square test was used to compare the tumor conspicuity during each phase between two groups.Results At artery phase,five lesions with group A showed hyperattenuation comparing with the pancreas parenchyma,three lesions with group A showed non-hyperattenuation; Fifteen lesions with group B showed non-hyperattenuation,and one lesion showed hyperattenuation.At parenchymal phase,six lesions with group A showed hyperattenuation comparing with the pancreas parenchyma,two lesions with group A showed non-hyperattenuation; Fifteen lesions with group B showed non-hyperattenuation,and one lesion showed hyperattenuation.At delay phase,two lesions with group A showed hyperattenuation comparing with the pancreas parenchyma,six lesions with group A showed non-hyperattenuation; Thirteen lesions with group B showed non-hyperattenuation,and three lesions showed hyperattenuation.The difference of tumor conspicuity between two groups at artery phase and parenchymal phase was significant(p<0.01)by chisquare test.Conclusion In contrast-enhanced image examinations of the patients with PNETs,the tumor conspicuity at artery and parenchymal phases comparing with the pancreas parenchyma can predict the pathological tumor grades of WHO.