MRI assessed pancreatic morphology and exocrine function are associated with disease burden in chronic pancreatitis

作者:Madzak Adnan; Olesen Soren Schou; Poulsen Jakob Lykke; Mark E**en Bolvig; Drewes A**jorn Mohr; Frokjaer Jens Brondum*
来源:European Journal of Gastroenterology and Hepatology, 2017, 29(11): 1269-1275.
DOI:10.1097/MEG.0000000000000955

摘要

Background and aim The aim of this study was to explore the association between morphological and functional secretin-stimulated MRI parameters with hospitalization, quality of life (QOL), and pain in patients with chronic pancreatitis (CP). Patients and methods This prospective cohort study included 82 patients with CP. Data were obtained from clinical information, QOL, and pain as assessed by questionnaires (The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and modified Brief Pain Inventory short form). Secretin-stimulated MRI morphological parameters included pancreatic gland volume, main pancreatic duct diameter, the modified Cambridge Classification of Duct Abnormality, apparent diffusion coefficient, fat signal fraction, and the pancreatic secretion volume as a functional parameter. The primary outcomes were time to first hospitalization related to the CP, as well as annual hospitalization frequency and duration. The secondary outcomes were pain severity, QOL, and pain interference scores. Results A main pancreatic duct diameter below 5mm was associated with reduced time to first hospitalization (hazard ratio= 2.06; 95% confidence interval: 1.02-4.17; P= 0.043). Pancreatic secretion volume was correlated with QOL (r= 0.31; P = 0.0072) and pain interference score (r=-0.27; P= 0.032), and fecal elastase was also correlated with QOL (r= 0.28; P = 0.017). However, functional and morphological findings were not related to pain intensity. Conclusion Advanced pancreatic imaging techniques may be a highly sensitive tool for prognostication and monitoring of disease activity and its consequences.

  • 出版日期2017-11