Quantitative MR Evaluation of Chronic Pancreatitis: Extracellular Volume Fraction and MR Relaxometry.
Quantitative MR Evaluation of Chronic Pancreatitis: Extracellular Volume Fraction and MR Relaxometry.
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DOI：
10.2214/ajr.17.18606
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Akisik F
中科院分区：
文献类型：
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作者：
Tirkes T;Lin C;Cui E;Deng Y;Territo PR;Sandrasegaran K;Akisik F
本研究的目的是确定细胞外容积分数和T1标测是否可用于诊断慢性胰腺炎（CP）。这项符合HIPAA的研究分析了2016年5月至2017年2月期间接受MR成像的143例连续CP和非CP患者。根据纳入和排除标准（考虑病史、临床和实验室检查结果）选择患者进行研究。符合条件的患者（n = 119）根据MRCP结果分组为正常（n = 60）或轻度（n = 22）、中度（n = 27）或重度（n = 10）CP，使用剑桥分类作为参考标准。在非增强和晚期对比增强阶段使用3D双翻转角梯度回波序列采集T1图。所有患者均在相同的3-T扫描仪上使用相同的成像参数、造影剂和剂量进行成像。平均细胞外容积分数和T1弛豫时间在研究组内显著不同（单因素方差分析，p < 0.001）。使用AUC曲线分析，细胞外容积分数> 0.27对于CP的诊断显示92%（54/59）和77%（46/60）的敏感性（AUC = 0.90）。T1弛豫时间> 950 ms显示64%的灵敏度（38/59）和88%的特异性（53/60）（AUC = 0.80）。结合细胞外容积分数和T1标测的敏感性为85%（50/59），特异性为92%（55/60）（AUC = 0.94）。细胞外体积分数和T1映射可以提供定量指标，用于确定腺泡细胞损失的存在和严重程度，并有助于CP的诊断。
The purpose of this study was to determine if extracellular volume fraction and T1 mapping can be used to diagnose chronic pancreatitis (CP). This HIPAA-compliant study analyzed 143 consecutive patients with and without CP who underwent MR imaging between May 2016 and February 2017. Patients were selected for the study according to inclusion and exclusion criteria that considered history and clinical and laboratory findings. Eligible patients (n = 119) were grouped as normal (n = 60) or with mild (n = 22), moderate (n = 27), or severe (n = 10) CP on the basis of MRCP findings using the Cambridge classification as the reference standard. T1 maps were acquired in unenhanced and late contrast-enhanced phases using a 3D dual flip-angle gradient-echo sequence. All patients were imaged on the same 3-T scanner using the same imaging parameters, contrast agent, and dosage. Mean extracellular volume fractions and T1 relaxation times were significantly different within the study groups (one-way ANOVA, p < 0.001). Using the AUC curve analysis, extracellular volume fraction of > 0.27 showed 92% sensitivity (54/59) and 77% specificity (46/60) for the diagnosis of CP (AUC = 0.90). A T1 relaxation time of > 950 ms revealed 64% sensitivity (38/59) and 88% specificity (53/60) (AUC = 0.80). Combining extracellular volume fraction and T1 mapping yielded sensitivity of 85% (50/59) and specificity of 92% (55/60) (AUC = 0.94). Extracellular volume fraction and T1 mapping may provide quantitative metrics for determining the presence and severity of acinar cell loss and aid in the diagnosis of CP.