Gilbeau J P, Poncelet V, Libon E, Derue G, Heller F R
Department of Radiology, Hôpital de Jolimont, Haine Saint Paul, Belgium.
AJR Am J Roentgenol. 1992 Sep;159(3):527-31. doi: 10.2214/ajr.159.3.1503017.
Insulin has a trophic effect on pancreatic acinar tissue, so the pancreas might be expected to atrophy in persons who have diabetes. Accordingly, we analyzed the density, contour (smooth or lobulated), and thickness of the pancreas on CT scans of diabetic patients and compared the results with those in control subjects. The prevalence of pancreatic lobulation (incisurae deeper than 2 mm) and its correlation with age in diabetic and control subjects were determined. The thickness of the pancreas was measured at three levels (head, body, tail). Three groups of diabetic patients were examined: 20 insulin-dependent patients, 25 patients not treated with nor dependent on insulin, and 12 patients treated with but not dependent on insulin. A control group included 57 nondiabetic patients. The ages of the control subjects were similar to those of the diabetic patients. The statistical significance of the differences between groups of diabetic patients and control subjects was estimated by using Student's t test for the values of density and thickness and the chi 2-test for the prevalence of pancreatic lobulation. The density of the pancreas in diabetic patients and control subjects was not statistically different. Diabetic patients had increased lobulation of the pancreas. All parts of the pancreas tended to be smaller in diabetic patients, but the degree of reduction varied. It was modest in the patients not treated with insulin, pronounced in insulin-dependent patients, and intermediate in non-insulin-dependent, insulin-treated patients. Moreover, the size of the body was significantly reduced in all three groups, whereas the size of the pancreatic head was preserved in patients not treated with insulin. In conclusion, CT of the pancreas shows that although density in diabetic patients is normal, lobulation is increased. Reduction in size involves the body of the pancreas more than other parts of the gland and is more pronounced in insulin-treated diabetic patients. CT of the pancreas might be useful to predict which diabetic patients will require insulin therapy.
胰岛素对胰腺腺泡组织具有营养作用，因此糖尿病患者的胰腺可能会出现萎缩。据此，我们分析了糖尿病患者CT扫描图像中胰腺的密度、轮廓（光滑或分叶状）及厚度，并将结果与对照组进行比较。测定了糖尿病患者和对照组中胰腺分叶（切迹深度超过2mm）的发生率及其与年龄的相关性。在胰腺的三个层面（头部、体部、尾部）测量胰腺厚度。研究了三组糖尿病患者：20例胰岛素依赖型患者、25例未接受胰岛素治疗也不依赖胰岛素的患者以及12例接受胰岛素治疗但不依赖胰岛素的患者。对照组包括57例非糖尿病患者。对照组患者的年龄与糖尿病患者相似。采用Student's t检验评估糖尿病患者组与对照组之间密度和厚度值差异的统计学意义，采用卡方检验评估胰腺分叶发生率的差异。糖尿病患者和对照组胰腺的密度无统计学差异。糖尿病患者胰腺分叶增加。糖尿病患者胰腺各部分均有变小趋势，但缩小程度各异。未接受胰岛素治疗的患者缩小程度较轻，胰岛素依赖型患者缩小明显，非胰岛素依赖型且接受胰岛素治疗的患者缩小程度居中。此外，三组患者胰腺体部大小均显著减小，而未接受胰岛素治疗患者的胰头大小保持不变。总之，胰腺CT显示，糖尿病患者胰腺密度虽正常，但分叶增加。胰腺大小缩小以体部最为明显，且在接受胰岛素治疗的糖尿病患者中更为显著。胰腺CT可能有助于预测哪些糖尿病患者需要胰岛素治疗。
