Ibrahim Ramez M, Solanki Shantanu, Qiao Wei, Hwang Hyunsoo, Singh Ben S, Cazacu Irina M, Saftoiu Adrian, Katz Matthew H G, Kim Michael P, McAllister Florencia, Bhutani Manoop S
Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Endosc Ultrasound. 2025 Jan-Feb;14(1):13-19. doi: 10.1097/eus.0000000000000109. Epub 2025 Mar 3.
Fatty pancreas (FP), traditionally perceived as a benign finding, has been undergoing scrutiny lately due to growing evidence linking it to various disease states, including increased risk for pancreatic cancer (PC).
A retrospective study of patients who underwent EUS at a single institution from August 2007 to October 2023, conducted by one endosonographer with more than 25 years of experience. Focusing on individuals identified with FP during EUS, we compared these findings with corresponding findings on computed tomography/magnetic resonance imaging (CT/MRI) conducted within 3 months or 1 year prior to or following EUS.
Ninety-one patients were included and identified as having FP on their EUS exams. The most common indication for EUS was PC screening in high-risk patients (35.16%). At the time of conducting EUS, 65.93% of patients had a body mass index (BMI) ≥30, 63.73% had hypertension, and 32.96% had type 2 diabetes mellitus (DM). Of the 91 patients, 70 had CT or MRI done within 3 months of the EUS date, and only 15 (21.43%) had FP reported on imaging. All 91 patients had CT or MRI within 1 year, and only 16 (17.58%) had FP reported on imaging.
Only 21.43% of patients had FP on their CT/MRI within 3 months despite EUS findings, suggesting either lower accuracy of CT/MRI compared to EUS in identifying FP or potential underreporting in a real-world setting, even in a tertiary care center. This discrepancy in reporting is noteworthy considering FP's role as a potential precursor to several important conditions and promoting pancreatic carcinogenesis pathways.
脂肪性胰腺（FP）传统上被视为一种良性表现，但由于越来越多的证据表明它与多种疾病状态相关，包括胰腺癌（PC）风险增加，近来受到了密切关注。
对2007年8月至2023年10月在单一机构接受超声内镜检查（EUS）的患者进行回顾性研究，由一位拥有超过25年经验的内镜超声医师实施。针对在EUS检查中被诊断为FP的患者，我们将这些检查结果与在EUS检查前或后3个月或1年内进行的计算机断层扫描/磁共振成像（CT/MRI）的相应结果进行了比较。
纳入91例患者，其EUS检查确诊为FP。EUS最常见的适应证是对高危患者进行PC筛查（35.16%）。在进行EUS检查时，65.93%的患者体重指数（BMI）≥30，63.73%的患者患有高血压，32.96%的患者患有2型糖尿病（DM）。在这91例患者中，70例在EUS检查日期后的3个月内进行了CT或MRI检查，其中只有15例（21.43%）在影像学检查中报告有FP。所有91例患者在1年内都进行了CT或MRI检查，只有16例（17.58%）在影像学检查中报告有FP。
尽管有EUS检查结果，但仅21.43%的患者在3个月内的CT/MRI检查中发现有FP，这表明在识别FP方面，CT/MRI的准确性低于EUS，或者在实际临床环境中可能存在漏报情况，即使是在三级医疗中心也是如此。考虑到FP作为几种重要疾病的潜在前驱因素以及促进胰腺癌发生途径所起的作用，这种报告差异值得关注。
