Utility of dual-energy CT and advanced multiparametric MRI based imaging biomarkers of pancreatic fibrosis in grading the severity of chronic pancreatitis

IF 2.3 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Abdominal Radiology Pub Date : 2024-06-20 DOI:10.1007/s00261-024-04443-0

Mohak Narang, Anup Singh, Soumya Jagannath Mahapatra, Deepak Gunjan, Sanjay Sharma, Deep Narayan Srivastava, Rajni Yadav, Nihar Ranjan Dash, Virinder Kumar Bansal, Ravindra Mohan Pandey, Pramod Kumar Garg, Kumble Seetharama Madhusudhan

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Abstract

Purpose

To non-invasively quantify pancreatic fibrosis and grade severity of chronic pancreatitis (CP) on dual-energy CT (DECT) and multiparametric MRI (mpMRI).

Methods

We included 72 patients (mean age:30years; 59 men) with suspected or confirmed CP from December 2019 to December 2021 graded as equivocal(n = 20), mild(n = 18), and moderate-marked(n = 34) using composite imaging and endoscopic ultrasound criteria. Study patients underwent multiphasic DECT and mpMRI of the abdomen. Normalized iodine concentration(NIC) and fat fraction(FF) on 6-minute delayed DECT, and T1 relaxation time(T1Rt), extracellular volume fraction(ECVf), intravoxel incoherent motion-based perfusion fraction(PF), and magnetization transfer ratio(MTR) on mpMRI of pancreas were compared. 20 renal donors(for DECT) and 20 patients with renal mass(for mpMRI) served as controls.

Results

NIC of pancreas in controls and progressive grades of CP were 0.24 ± 0.05, 0.80 ± 0.18, 1.06 ± 0.23, 1.40 ± 0.36, FF were 9.28 ± 5.89, 14.19 ± 5.29, 17.31 ± 5.99, 29.32 ± 12.22, T1Rt were 590.11 ± 61.13, 801.93 ± 211.01, 1006.79 ± 352.18, 1388.01 ± 312.23ms, ECVf were 0.07 ± 0.03, 0.30 ± 0.12, 0.41 ± 0.12, 0.53 ± 0.13, PF were 0.38 ± 0.04, 0.28 ± 0.07, 0.25 ± 0.09, 0.21 ± 0.05 and MTR were 0.12 ± 0.03, 0.15 ± 0.06, 0.21 ± 0.07, 0.26 ± 0.06, respectively. There were significant differences for all quantitative parameters between controls and mild CP; for NIC, PF, and ECVf between controls and progressive CP grades (p < 0.05). Area under curve for NIC, FF, T1Rt, ECVf, PF, and MTR in differentiating controls and mild CP were 1.00, 0.86, 0.95, 1.00, 0.90 and 0.84 respectively and for NIC, FF, ECVf and PF in differentiating controls and equivocal CP were 1.00, 0.76, 0.95 and 0.92 respectively.

Conclusion

DECT and mpMRI were useful in quantifying pancreatic fibrosis and grading the severity of CP. NIC was the most accurate marker.

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基于双能 CT 和先进的多参数 MRI 的胰腺纤维化成像生物标记物在慢性胰腺炎严重程度分级中的实用性。

目的：通过双能CT（DECT）和多参数磁共振成像（mpMRI）对胰腺纤维化进行无创量化，并对慢性胰腺炎（CP）的严重程度进行分级：我们纳入了2019年12月至2021年12月期间疑似或确诊CP的72名患者（平均年龄：30岁；59名男性），采用综合成像和内镜超声标准将其分级为等度（20人）、轻度（18人）和中度（34人）。研究患者接受了腹部多相 DECT 和 mpMRI 检查。比较了 6 分钟延迟 DECT 的归一化碘浓度（NIC）和脂肪分数（FF），以及胰腺 mpMRI 的 T1 松弛时间（T1Rt）、细胞外体积分数（ECVf）、体内非相干运动灌注分数（PF）和磁化传递比（MTR）。20 名肾脏供体（DECT）和 20 名肾脏肿块患者（mpMRI）作为对照组：结果：对照组和进展期 CP 的胰腺 NIC 分别为 0.24 ± 0.05、0.80 ± 0.18、1.06 ± 0.23、1.40 ± 0.36，FF 分别为 9.28 ± 5.89、14.19 ± 5.29、17.31 ± 5.99、29.32 ± 12.22，T1Rt 分别为 590.11 ± 61.13、801.93 ± 211.01、1006.79 ± 352.18、1388.01 ± 312.23ms，ECVf 分别为 0.07 ± 0.03、0.30 ± 0.12、0.41 ± 0.12、0.53 ± 0.13，PF 分别为 0.38 ± 0.04、0.28 ± 0.07、0.25 ± 0.09、0.21 ± 0.05，MTR 分别为 0.12 ± 0.03、0.15 ± 0.06、0.21 ± 0.07、0.26 ± 0.06。DECT 和 mpMRI 在量化胰腺纤维化和 CP 严重程度分级方面非常有用。NIC是最准确的标记。

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来源期刊

Abdominal Radiology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

8.30%

发文量

334

期刊介绍： Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section. Reasons to Publish Your Article in Abdominal Radiology: · Official journal of the Society of Abdominal Radiology (SAR) · Published in Cooperation with: European Society of Gastrointestinal and Abdominal Radiology (ESGAR) European Society of Urogenital Radiology (ESUR) Asian Society of Abdominal Radiology (ASAR) · Efficient handling and Expeditious review · Author feedback is provided in a mentoring style · Global readership · Readers can earn CME credits