Purpose <p>T1 signal intensity ratio (SIR) on MRI has not been rigorously evaluated as a noninvasive method to detect pancreatic fibrosis in patients undergoing surgery for recurrent acute (RAP) and chronic pancreatitis (CP). The aim of our study was to evaluate the association between histologic fibrosis score (FS) and T1 SIR and contrast enhancement of the pancreas on MRI among patients with RAP and CP undergoing total pancreatectomy with islet autotransplantation (TPIAT).</p> Methods <p>Patients who underwent MRI &lt; 6&#xa0;months before TPIAT between 2011 and 2023 were classified into 3 groups: definite CP (n = 23) and indeterminate CP (n = 11) by M-ANNHEIM criteria; and RAP defined as ≥ 2 episodes of imaging-documented acute pancreatitis (n = 22). The perilobular and intralobular fibrosis of each surgical biopsy was scored from 0 to 6. The FS was the sum of perilobular and intralobular fibrosis (0–12). We measured the T1 signal intensity of the pancreas and reference organs using pre-contrast T1-weighted fat-saturated (T1WFS) sequences to obtain the T1 SIR. We also measured the T1 signal intensity of the pancreas in the pre-contrast, arterial, venous, and delayed phases.</p> Results <p>A total of 56 patients were included. The median FS was 6.25 (range 0–12). Pancreas-to-spleen T1 SIR (p = 0.004) and pancreas-to-paraspinal T1 SIR (p = 0.03) were significantly associated with pancreatic fibrosis after adjusting for age, BMI, exocrine insufficiency, fat fraction, diabetes mellitus, and clinical diagnosis. Analysis of the enhancement curves showed that the venous phase of T1 signal intensity can differentiate between indeterminate CP, RAP and definite CP (p &lt; 0.004 for all).</p> Conclusion <p>Both the T1 SIR of the pancreas-to-spleen and pancreas-to-paraspinal muscle show an independent association with fibrosis. T1 SIR demonstrates a significant association with histologically quantified pancreatic fibrosis and may serve as a promising noninvasive imaging biomarker pending further validation.</p>

错误:搜索内容不能为空,请输入英文关键词
错误:关键词超出字数限制,请精简
高级检索

MRI T1 signal intensity ratios correlate with fibrosis in recurrent acute and chronic pancreatitis

  • Aida A. Metri,
  • Mahya Faghih,
  • Elizabeth Thompson,
  • Michael Noë,
  • Rifat Mannan,
  • Rita Kalyani,
  • Elham Afghani,
  • Venkata S. Akshintala,
  • Daniel Warren,
  • Niraj M. Desai,
  • Zhaoli Sun,
  • Christi Walsh,
  • Martin Makary,
  • Ralph Hruban,
  • Jin He,
  • Vikesh K. Singh,
  • Atif Zaheer

摘要

Purpose

T1 signal intensity ratio (SIR) on MRI has not been rigorously evaluated as a noninvasive method to detect pancreatic fibrosis in patients undergoing surgery for recurrent acute (RAP) and chronic pancreatitis (CP). The aim of our study was to evaluate the association between histologic fibrosis score (FS) and T1 SIR and contrast enhancement of the pancreas on MRI among patients with RAP and CP undergoing total pancreatectomy with islet autotransplantation (TPIAT).

Methods

Patients who underwent MRI < 6 months before TPIAT between 2011 and 2023 were classified into 3 groups: definite CP (n = 23) and indeterminate CP (n = 11) by M-ANNHEIM criteria; and RAP defined as ≥ 2 episodes of imaging-documented acute pancreatitis (n = 22). The perilobular and intralobular fibrosis of each surgical biopsy was scored from 0 to 6. The FS was the sum of perilobular and intralobular fibrosis (0–12). We measured the T1 signal intensity of the pancreas and reference organs using pre-contrast T1-weighted fat-saturated (T1WFS) sequences to obtain the T1 SIR. We also measured the T1 signal intensity of the pancreas in the pre-contrast, arterial, venous, and delayed phases.

Results

A total of 56 patients were included. The median FS was 6.25 (range 0–12). Pancreas-to-spleen T1 SIR (p = 0.004) and pancreas-to-paraspinal T1 SIR (p = 0.03) were significantly associated with pancreatic fibrosis after adjusting for age, BMI, exocrine insufficiency, fat fraction, diabetes mellitus, and clinical diagnosis. Analysis of the enhancement curves showed that the venous phase of T1 signal intensity can differentiate between indeterminate CP, RAP and definite CP (p < 0.004 for all).

Conclusion

Both the T1 SIR of the pancreas-to-spleen and pancreas-to-paraspinal muscle show an independent association with fibrosis. T1 SIR demonstrates a significant association with histologically quantified pancreatic fibrosis and may serve as a promising noninvasive imaging biomarker pending further validation.