Bieliuniene Edita, Frøkjær Jens Brøndum, Pockevicius Alius, Kemesiene Jurate, Lukosevicius Saulius, Basevicius Algidas, Barauskas Giedrius, Dambrauskas Zilvinas, Gulbinas Antanas
Department of Radiology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Radiology, Aalborg University Hospital.
Pancreas. 2019 Jan;48(1):85-93. doi: 10.1097/MPA.0000000000001206.
The aim of this study was to evaluate the utility of magnetic resonance imaging (MRI) for the noninvasive assessment of pancreatic fibrosis (PF).
Fifty-two patients who underwent surgical resection of the pancreas, histological examination of resection margins, preoperative abdominal MRI, and fecal elastase-1 test were enrolled in the study. Pancreatic tissue was identified on the MRI T1-, T2-, and diffusion-weighted imaging sequences. Apparent diffusion coefficient (ADC) was measured at the expected resection margin of the pancreas.
There was a significant negative correlation between the ADC mean and histologically determined PF (r = -0.752, P = 0.001). For equal to or greater than 25% of PF, the ADC cutoff value was 1.331 or less, with a sensitivity of 77% and specificity of 88%. The unenhanced T1-weighted signal intensity ratio (T1SI) cutoff value was 172.1 or less. For equal to or greater than 50% of PF, the ADC cutoff value was 1.316 or less with a sensitivity of 85% and specificity of 88%. The highest sensitivity was obtained by combining ADC and T1SI values.
Combining both the ADC and T1SI measurement allows the detection of early PF with good sensitivity and specificity. Magnetic resonance imaging has the advantage of being noninvasive and widely used in the clinical setting, thus making our results easily transferable to routine clinical practice.
本研究旨在评估磁共振成像（MRI）在胰腺纤维化（PF）无创评估中的应用价值。
52例接受胰腺手术切除、切缘组织学检查、术前腹部MRI及粪便弹性蛋白酶-1检测的患者纳入本研究。在MRI的T1、T2和扩散加权成像序列上识别胰腺组织。在胰腺预期切除边缘测量表观扩散系数（ADC）。
ADC平均值与组织学确定的PF之间存在显著负相关（r = -0.752，P = 0.001）。对于PF等于或大于25%的情况，ADC临界值为1.331或更低，灵敏度为77%，特异性为88%。未增强T1加权信号强度比（T1SI）临界值为172.1或更低。对于PF等于或大于50%的情况，ADC临界值为1.316或更低，灵敏度为85%，特异性为88%。通过结合ADC和T1SI值可获得最高灵敏度。
结合ADC和T1SI测量能够以良好的灵敏度和特异性检测早期PF。磁共振成像具有无创且在临床环境中广泛应用的优势，因此我们的结果易于转化为常规临床实践。
