Prediction of pancreatic atrophy after steroid therapy using equilibrium-phase contrast computed tomography imaging in autoimmune pancreatitis
Prediction of pancreatic atrophy after steroid therapy using equilibrium-phase contrast computed tomography imaging in autoimmune pancreatitis
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DOI：
10.1002/jgh3.12316
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发表时间：
2020-03-10
期刊：
影响因子：
1.7
通讯作者：
Kodama, Yuzo
中科院分区：
文献类型：
--
作者：
Yamada, Yasutaka;Masuda, Atsuhiro;Kodama, Yuzo
背景和目的：目前还没有建立预测自身免疫性胰腺炎（AIP）类固醇治疗后胰腺萎缩的影像学工具。由于延迟平衡相对比增强计算机断层扫描（CE-CT）可能反映间质纤维化，我们评估了平衡相CT成像预测胰腺atrophic. Methods的能力：46例类固醇治疗的AIP患者在我们的大学医院进行对比增强CT包括在这项回顾性研究。测量平扫图像（NC）和平衡期图像（EP）的CT衰减（Hounsfield单位[HU]）值以及NC和EP图像之间HU值的差异（HU）。在激素治疗前（治疗前）和治疗后（治疗后）在CE-CT中测量胰腺体积。计算减容率。结果：激素治疗前的胰腺CT值与激素治疗后的胰腺萎缩程度相关，激素治疗后的胰腺萎缩程度与激素治疗前的胰腺CT值相关（萎缩vs非萎缩分别为114.5 ± 12.8 vs 99.5 ± 11.1，P = 0.0002; 70.9 ± 14.72 vs 57.2 ± 13.1，P = 0.003），但NC图像的CT值并非如此（P = 0.42）。激素治疗前EP和SPECT图像的CT值与激素治疗后的CT值（EP图像r =-0.70，P =0.002; SPECT图像r =-0.68，P =0.03）和激素治疗后的体积缩小率（EP图像r =-0.55，P =0.0001; SPECT图像r =-0.45，P =0.002）相关。结论：平衡相位对比CT成像有助于预测AIP患者激素治疗后的胰腺萎缩。
Background and Aims: Imaging tools for predicting pancreatic atrophy after steroid therapy in autoimmune pancreatitis (AIP) have not been established. As delayed equilibrium-phase contrast enhancement in computed tomography (CE-CT) may reflect interstitial fibrosis, we evaluated the ability of equilibrium-phase CT imaging for predicting pancreatic atrophy.Methods: Forty-six steroid-treated AIP patients who underwent contrast-enhanced CT at our university hospital were included in this retrospective study. CT attenuation (Hounsfield units [HU]) values in noncontrast images (NC) and equilibrium-phase images (EP) and the differences in HU values between NC and EP images (SUB) were measured. Pancreatic volume was measured in CE-CT before (Vol(pre)) and after (Vol(post)) steroid therapy. The volume reduction rate was calculated. The relationships of CT values with pancreatic atrophy, Vol(post), volume reduction rate, and diabetes exacerbation were investigated.Results: CT values in the EP and SUB images before steroid therapy were associated with pancreatic atrophy after steroid therapy (atrophyvsnonatrophy 114.5 +/- 12.8 vs 99.5 +/- 11.1, P = 0.0002; 70.9 +/- 14.72 vs 57.2 +/- 13.1,P = 0.003, respectively), but CT values in NC images were not (P= 0.42). CT values in EP and SUB images before steroid therapy were correlated with Vol(post)(EP images r = -0.70,P= 0.002; SUB images r = -0.68,P = 0.03) and volume reduction rate after steroid therapy (EP images: r = -0.55,P< 0.0001; SUB images r = -0.45, P = 0.002). Diabetes exacerbation was associated with higher EP and SUB values (P = 0.009 and P = 0.04, respectively).Conclusion: Equilibrium-phase contrast CT imaging may facilitate prediction of pancreatic atrophy after steroid therapy in AIP.