Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Jpn J Radiol. 2022 Jul;40(7):696-702. doi: 10.1007/s11604-022-01256-3. Epub 2022 Mar 2.
To evaluate the association of the pancreatic exocrine function estimated by cine-dynamic magnetic resonance cholangiopancreatography (MRCP) using a spatially selective inversion-recovery (IR) pulse with the pancreatic endocrine function estimated by the T1 relaxation time of the pancreatic parenchyma and HbA1c values.
Forty-three patients with suspected hepatobiliary or pancreatic diseases were included. Patients were classified into three groups: HbA1c < 5.7% (normal group), 5.7% ≤ HbA1c < 6.5% (prediabetes group), and HbA1c ≥ 6.5% (diabetes group). The frequency of the secretory flow of the pancreatic juice was observed within the area of the IR pulse, and the moving distance (mean secretion grade) of the pancreatic juice inflow within the area of the IR pulse on cine-dynamic MRCP, and the T1 relaxation time of the pancreatic parenchyma on the T1 map images were assessed. The MR imaging measurements were compared using Spearman's rank correlation coefficient analysis and the Kruskal-Wallis and Mann-Whitney U tests.
Both the mean secretion grade and frequency of the pancreatic secretory inflow had a significant negative correlation with the T1 relaxation time of the pancreatic parenchyma (r = - 0.335, p = 0.028 and r = - 0.305, p = 0.047, respectively) and HbA1c values (r = - 0.308, p = 0.044 and r = - 0.313, p = 0.041, respectively). Both the mean secretion grade and frequency of the pancreatic secretory inflow in the elevated HbA1c (prediabetes and diabetes) group were significantly lower than those in the normal group (p = 0.030 and p = 0.029, respectively).
The pancreatic exocrine function estimated by cine-dynamic MRCP was significantly lower in patients with prediabetes and diabetes than in controls. Cine-dynamic MRCP with a spatially selective IR pulse may be useful for the early diagnosis of pancreatic exocrine insufficiency in patients with pancreatic endocrine insufficiency.
评估使用空间选择性反转恢复（IR）脉冲的电影动态磁共振胆胰管成像（MRCP）估计的胰腺外分泌功能与胰腺实质 T1 弛豫时间和 HbA1c 值估计的胰腺内分泌功能之间的相关性。
纳入 43 例疑似肝胆或胰腺疾病的患者。患者分为三组：HbA1c<5.7%（正常组）、5.7%≤HbA1c<6.5%（糖尿病前期组）和 HbA1c≥6.5%（糖尿病组）。观察 IR 脉冲区域内胰液分泌的频率，评估 IR 脉冲区域内胰液流入的移动距离（平均分泌等级），以及 T1 地图图像上胰腺实质的 T1 弛豫时间。使用 Spearman 秩相关系数分析、Kruskal-Wallis 和 Mann-Whitney U 检验比较磁共振成像测量值。
胰液分泌流入的平均分泌等级和频率均与胰腺实质的 T1 弛豫时间（r=-0.335，p=0.028 和 r=-0.305，p=0.047）和 HbA1c 值（r=-0.308，p=0.044 和 r=-0.313，p=0.041）呈显著负相关。HbA1c 升高（糖尿病前期和糖尿病）组的平均分泌等级和胰液分泌流入频率均明显低于正常组（p=0.030 和 p=0.029）。
与对照组相比，糖尿病前期和糖尿病患者的电影动态 MRCP 估计的胰腺外分泌功能明显降低。使用空间选择性 IR 脉冲的电影动态 MRCP 可能有助于早期诊断胰腺内分泌功能不全患者的胰腺外分泌不足。
