Hong Tae Ho, Choi Joon-Il, Park Michael Yong, Rha Sung Eun, Lee Young Joon, You Young Kyoung, Choi Moon Hyung
Tae Ho Hong, Young Kyoung You, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
World J Gastroenterol. 2017 Mar 21;23(11):2044-2051. doi: 10.3748/wjg.v23.i11.2044.
To evaluate the correlation between subjective assessments of pancreatic hardness based on the palpation, objective measurements using a durometer, and magnetic resonance imaging (MRI) findings for assessing pancreatic hardness.
Eighty-three patients undergoing pancreatectomies were enrolled. An experienced surgeon subjectively evaluated the pancreatic hardness in the surgical field by palpation. The pancreatic hardness was also objectively evaluated using a durometer. Preoperative MRI findings were evaluated by a radiologist in terms of the apparent diffusion coefficient (ADC) values, the relative signal intensity decrease (RSID) of the pancreatic parenchyma, and the diameter of the pancreatic parenchyma and duct. Durometer measurement results, ADC values, RSID, pancreatic duct and parenchyma diameters, and the ratio of the diameters of the duct and parenchyma were compared between pancreases judged to be soft or hard pancreas on the palpation. A correlation analysis was also performed between the durometer and MRI measurements.
The palpation assessment classified 44 patients as having a soft pancreas and 39 patients as having a hard pancreas. ADC values were significantly lower in the hard pancreas group. The ductal diameter and duct-to-pancreas ratio were significantly higher in the hard pancreas group. For durometer measurements, a correlation analysis showed a positive correlation with the ductal diameter and the duct-to-pancreas ratio and a negative correlation with ADC values.
Hard pancreases showed lower ADC values, a wider pancreatic duct diameter and a higher duct-to-pancreas ratio than soft pancreases. Additionally, the ADC values, diameter of the pancreatic duct and duct-to-pancreas ratio were closely correlated with the durometer results.
评估基于触诊的胰腺硬度主观评估、使用硬度计的客观测量以及用于评估胰腺硬度的磁共振成像（MRI）结果之间的相关性。
纳入83例行胰腺切除术的患者。一名经验丰富的外科医生通过触诊主观评估手术视野中的胰腺硬度。还使用硬度计对胰腺硬度进行客观评估。术前MRI结果由放射科医生根据表观扩散系数（ADC）值、胰腺实质的相对信号强度降低（RSID）以及胰腺实质和导管的直径进行评估。比较在触诊中判断为软胰腺或硬胰腺的胰腺之间的硬度计测量结果、ADC值、RSID、胰管和实质直径以及导管与实质直径之比。还对硬度计测量结果与MRI测量结果进行了相关性分析。
触诊评估将44例患者分类为软胰腺，39例患者分类为硬胰腺。硬胰腺组的ADC值显著更低。硬胰腺组的导管直径和导管与胰腺的比值显著更高。对于硬度计测量，相关性分析显示与导管直径和导管与胰腺的比值呈正相关，与ADC值呈负相关。
与软胰腺相比，硬胰腺的ADC值更低，胰管直径更宽，导管与胰腺的比值更高。此外，ADC值、胰管直径和导管与胰腺的比值与硬度计测量结果密切相关。
