Williams A J K, Chau W, Callaway M P, Dayan C M
Clinical Science at North Bristol, University of Bristol, UK.
Diabet Med. 2007 Jan;24(1):35-40. doi: 10.1111/j.1464-5491.2007.02027.x.
To validate magnetic resonance imaging (MRI) for monitoring pancreatic atrophy in Type 1 diabetes.
Twelve male patients with Type 1 diabetes of duration >or= 10 years (median age 28, range 19-32 years) and 12 healthy controls (median age 30, range 22-36 years) were invited for two abdominal MRI scans, 14 days apart. Four sequences were used: standard T1-weighted; standard T2-weighted; volumetric interpolated breath-hold examination (VIBE); and T1-weighted breath hold with fat suppression (T1BHFS). The pancreas was identified on coded images by one observer and volumes estimated by interpolation.
Eleven patients and all controls were scanned twice. Visualization of the pancreas was best with VIBE and T1BHFS, allowing volume estimation from 47 and 46 scans, respectively. The pancreatic volume of patients estimated from these sequences were half those of controls (52.4 ml, +/- 17.1 ml, mean +/- sd) vs. (101 ml, +/- 19.5 ml, P < 0.001) and estimates showed little bias between visits; mean difference 1.1 ml (95% CI; -3.1 to 5.3 ml, P = 0.61) using VIBE and -2.6 ml (-5.8 to 0.6 ml, P = 0.03) using T1BHFS. Both sequences gave similar precision; the standard deviation of the differences in volume estimates between visits was 9.7 ml for VIBE and 7.3 ml for T1BHFS, although mean volumes estimated from T1BHFS were 4.9 ml lower (-8.2 to -1.7 ml, P = 0.005).
Pancreatic volume can be measured reliably using MRI and shows a 48% reduction in long-standing Type 1 diabetes as compared with age-matched normal subjects. MRI should prove useful in determining the natural history of pancreatic atrophy in diabetes.
验证磁共振成像（MRI）用于监测1型糖尿病患者胰腺萎缩的情况。
邀请12名病程≥10年的1型糖尿病男性患者（中位年龄28岁，范围19 - 32岁）和12名健康对照者（中位年龄30岁，范围22 - 36岁）进行两次腹部MRI扫描，间隔14天。使用了四个序列：标准T1加权；标准T2加权；容积内插屏气检查（VIBE）；以及脂肪抑制T1加权屏气（T1BHFS）。由一名观察者在编码图像上识别胰腺，并通过插值法估计体积。
11名患者和所有对照者均接受了两次扫描。VIBE和T1BHFS对胰腺的显示最佳，分别可从47次和46次扫描中估计体积。根据这些序列估计的患者胰腺体积仅为对照者的一半（52.4 ml，±17.1 ml，平均值±标准差）对比（101 ml，±19.5 ml，P < 0.001），且两次检查之间的估计偏差很小；使用VIBE时平均差异为1.1 ml（95%可信区间：-3.1至5.3 ml，P = 0.61），使用T1BHFS时为-2.6 ml（-5.8至0.6 ml，P = 0.03）。两个序列的精度相似；两次检查之间体积估计差异的标准差，VIBE为9.7 ml，T1BHFS为7.3 ml，尽管T1BHFS估计的平均体积低4.9 ml（-8.2至-1.7 ml，P = 0.005）。
使用MRI可可靠地测量胰腺体积，与年龄匹配的正常受试者相比，长期1型糖尿病患者的胰腺体积减少了48%。MRI在确定糖尿病胰腺萎缩的自然病程方面应会很有用。
