Burute Nishigandha, Nisenbaum Rosane, Jenkins David J, Mirrahimi Arash, Anthwal Shalini, Colak Errol, Kirpalani Anish
Department of Medical Imaging, St. Michael's Hospital and University of Toronto, Canada.
Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Canada; Dalla Lana School of Public Health, University of Toronto, Canada.
Pancreatology. 2014 Jul-Aug;14(4):268-74. doi: 10.1016/j.pan.2014.04.031. Epub 2014 May 9.
BACKGROUND/OBJECTIVES: To compare pancreas volume (PV) measurement using MRI-based planimetry in patients with Type 2 diabetes mellitus (DM) to PV in normoglycemic individuals.
Our institutional review board granted approval of this retrospective study with waiver of informed consent. We searched 2296 consecutive abdominal MRI studies performed at our hospital on patients with no pancreas pathology between September 1, 2010 and February 28, 2013, for those who also had a fasting plasma glucose and/or hemoglobin A1C within six months of the MRI examination. For those patients who met biochemical criteria for DM, we used medication and clinical records to confirm that 32 of these patients had Type 2 DM. The pancreas contours of 32 Type 2 diabetics and 50 normoglycemic individuals were then traced on non-gadolinium T1-weighted 3D fat suppressed gradient echo images by a radiologist trained in abdominal MRI to calculate PV. PV index (PVI) was calculated as PV/weight to adjust PV for each patient's weight. PVs and PVIs in both cohorts were compared using t-tests and regression models correcting for weight, age and gender.
Patients with Type 2 DM had significantly lower PVs than normoglycemic individuals (72.7 ± 20.7 cm(3) versus 89.6 ± 22.7 cm(3), p < 0.001), and significantly lower PVIs (1.0 ± 0.3 cm(3)/kg versus 1.3 ± 0.3 cm(3)/kg, p < 0.001). Using regression models, we found that given the same age, weight and gender, the PV in a patient with Type 2 DM was 17.9 mL (20%) lower compared to a normoglycemic individual (p < 0.001).
PV is reduced in Type 2 DM compared to normoglycemic individuals and can be measured using MRI without contrast injection.
背景/目的：比较2型糖尿病（DM）患者采用基于MRI的面积测量法测得的胰腺体积（PV）与血糖正常个体的胰腺体积。
我们的机构审查委员会批准了这项无需知情同意书的回顾性研究。我们在2010年9月1日至2013年2月28日期间于我院对无胰腺病变患者连续进行的2296例腹部MRI研究中，查找那些在MRI检查后六个月内还进行了空腹血糖和/或糖化血红蛋白检测的患者。对于符合DM生化标准的患者，我们通过药物治疗及临床记录确认其中32例患有2型DM。然后，由一名接受过腹部MRI培训的放射科医生在非钆增强T1加权3D脂肪抑制梯度回波图像上描绘32例2型糖尿病患者和50例血糖正常个体的胰腺轮廓，以计算PV。PV指数（PVI）计算为PV/体重，以根据每位患者的体重调整PV。使用t检验和校正体重、年龄及性别的回归模型比较两组人群的PV和PVI。
2型DM患者的PV显著低于血糖正常个体（72.7±20.7 cm³对89.6±22.7 cm³，p<0.001），且PVI也显著更低（1.0±0.3 cm³/kg对1.3±0.3 cm³/kg，p<0.001）。通过回归模型，我们发现，在年龄、体重和性别相同的情况下，2型DM患者的PV比血糖正常个体低17.9 mL（20%）（p<0.001）。
与血糖正常个体相比，2型DM患者的PV减小，且无需注射造影剂即可通过MRI进行测量。
