Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
PLoS One. 2019 Dec 2;14(12):e0224921. doi: 10.1371/journal.pone.0224921. eCollection 2019.
Since pancreatic steatosis is reported as a possible risk factor for pancreatic cancer, the development of a non-invasive method to quantify pancreatic steatosis is needed. Proton density fat fraction (PDFF) measurement is a magnetic resonance imaging (MRI) based method for quantitatively assessing the steatosis of a region of interest (ROI). Although it is commonly used for quantification of hepatic steatosis, pancreatic PDFF can greatly vary depending on the ROI's location because of the patchy nature of pancreatic fat accumulation. In this study, we attempted to quantify pancreatic steatosis by fat-water MRI with improved reproducibility.
Using the MRI images of 159 patients with nonalcoholic fatty liver disease, we attempted to calculate the average PDFF of whole pancreas. We set ROIs covering the entire area of the pancreas appearing in every slice and calculated the average PDFF from all the voxels included in the pancreas. We named this average value as whole-pancreatic PDFF and evaluated the reproducibility of the measured values. In addition to whole-pancreatic PDFF, we measured the average PDFF of the pancreatic head (head-PDFF) and that of the pancreatic body plus tail separately and analyzed their correlation with the clinical characteristics of the patients.
The mean inter-examiner coefficient of variation of the whole-pancreatic PDFF was 11.39%. The whole-pancreatic PDFF was correlated with age (p = 0.039), body mass index (p = 0.0093) and presence/absence of diabetes (p = 0.0055). The serum level of low-density lipoprotein cholesterol was inversely correlated with the head-PDFF.
We developed a new measurement method of the pancreatic PDFF with greater reproducibility. Using this method, we characterized pancreatic steatosis in detail. This novel measurement method allows accurate estimation of the severity of pancreatic steatosis and is therefore useful for the detailed characterization of pancreatic steatosis.
由于胰腺脂肪变性被报道为胰腺癌的一个可能的危险因素，因此需要开发一种非侵入性的方法来定量评估胰腺脂肪变性。质子密度脂肪分数（PDFF）测量是一种基于磁共振成像（MRI）的方法，用于定量评估感兴趣区域（ROI）的脂肪变性。虽然它通常用于量化肝脂肪变性，但由于胰腺脂肪堆积的不均匀性，胰腺 PDFF 可能会因 ROI 的位置而有很大差异。在这项研究中，我们尝试使用改进的可重复性的脂肪水 MRI 来定量评估胰腺脂肪变性。
我们使用 159 例非酒精性脂肪性肝病患者的 MRI 图像，尝试计算整个胰腺的平均 PDFF。我们设置了覆盖每个切片中出现的整个胰腺区域的 ROI，并从包含在胰腺中的所有体素计算平均 PDFF。我们将这个平均值命名为全胰 PDFF，并评估了测量值的可重复性。除了全胰 PDFF 之外，我们还分别测量了胰头的平均 PDFF（胰头 PDFF）和胰体加胰尾的平均 PDFF，并分析了它们与患者临床特征的相关性。
全胰 PDFF 的观察者间变异系数的平均值为 11.39%。全胰 PDFF 与年龄（p=0.039）、体重指数（p=0.0093）和是否存在糖尿病（p=0.0055）相关。血清低密度脂蛋白胆固醇水平与胰头 PDFF 呈负相关。
我们开发了一种新的胰腺 PDFF 测量方法，具有更高的可重复性。使用这种方法，我们详细描述了胰腺脂肪变性。这种新的测量方法可以准确估计胰腺脂肪变性的严重程度，因此对胰腺脂肪变性的详细特征描述很有用。
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