Pancreatic stiffness quantified with MR elastography: Relationship to postoperative pancreatic fistula after pancreaticoenteric anastomosis

Yu Shi, Ying Liu, Feng Gao, Yanqing Liu, Shengzhen Tao, Yue Li, Kevin J. Glaser, Richard Lorne Ehman, Qiyong Guo

Research output: Contribution to journalArticle

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Abstract

Purpose: To describe the relationship between conventional magnetic resonance (MR) imaging parameters and MR elastography of the pancreas in association with pancreatic histologic features and occurrence of postoperative pancreatic fistula (POPF). Materials and Methods: Patients who underwent preoperative MR imaging (MR elastography and diffusion-, T1-, and T2-weighted imaging) followed by pancreatectomy with pancreaticoenteric anastomosis were included. The relationships between preoperative MR imaging parameters, demographic data, and intraoperative factors with POPF risk were analyzed with logistic regression analyses. The correlation of MR imaging parameters with histologic characteristics was evaluated with multivariate regression analysis. Results: A total of 112 patients (64 men, 48 women; median age, 58 years) were evaluated. Forty-two patients (37.5%) developed POPF and 20 (17.9%) developed high-grade POPF (grades B and C). Lower pancreatic stiffness (1.43 kPa; odds ratio [OR], 9.196; 95% confidence interval [CI]: 1.92, 43.98), nondilated main pancreatic duct (MPD) diameter (,3 mm; OR, 7.298; 95% CI: 1.51, 35.34), and larger stump area (211 mm2; OR, 9.210; 95% CI: 1.53, 55.26) were risk factors for POPF. Lower pancreatic stiffness (1.27 kPa; OR, 8.389; 95% CI: 1.88, 37.41) was the only independent predictor of high-grade POPF. Log-transformed pancreatic stiffness was independently associated with fibrosis (b = 0.060; 95% CI: 0.052, 0.068), acinar atrophy (b = 0.015; 95% CI: 0.003, 0.028), and lipomatosis (b = 20.016; 95% CI: 20.026, 20.006). Conclusion: Preoperative MR assessment of pancreatic stiffness, MPD diameter, and stump area are important predictors of POPF.

Original languageEnglish (US)
Pages (from-to)476-484
Number of pages9
JournalRadiology
Volume288
Issue number2
DOIs
StatePublished - Aug 1 2018

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Pancreatic Fistula
Elasticity Imaging Techniques
Confidence Intervals
Odds Ratio
Magnetic Resonance Imaging
Pancreatic Ducts
Regression Analysis
Lipomatosis
Pancreatectomy
Atrophy
Pancreas
Fibrosis
Magnetic Resonance Spectroscopy
Multivariate Analysis
Logistic Models
Demography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Pancreatic stiffness quantified with MR elastography : Relationship to postoperative pancreatic fistula after pancreaticoenteric anastomosis. / Shi, Yu; Liu, Ying; Gao, Feng; Liu, Yanqing; Tao, Shengzhen; Li, Yue; Glaser, Kevin J.; Ehman, Richard Lorne; Guo, Qiyong.

In: Radiology, Vol. 288, No. 2, 01.08.2018, p. 476-484.

Research output: Contribution to journalArticle

Shi, Yu ; Liu, Ying ; Gao, Feng ; Liu, Yanqing ; Tao, Shengzhen ; Li, Yue ; Glaser, Kevin J. ; Ehman, Richard Lorne ; Guo, Qiyong. / Pancreatic stiffness quantified with MR elastography : Relationship to postoperative pancreatic fistula after pancreaticoenteric anastomosis. In: Radiology. 2018 ; Vol. 288, No. 2. pp. 476-484.
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abstract = "Purpose: To describe the relationship between conventional magnetic resonance (MR) imaging parameters and MR elastography of the pancreas in association with pancreatic histologic features and occurrence of postoperative pancreatic fistula (POPF). Materials and Methods: Patients who underwent preoperative MR imaging (MR elastography and diffusion-, T1-, and T2-weighted imaging) followed by pancreatectomy with pancreaticoenteric anastomosis were included. The relationships between preoperative MR imaging parameters, demographic data, and intraoperative factors with POPF risk were analyzed with logistic regression analyses. The correlation of MR imaging parameters with histologic characteristics was evaluated with multivariate regression analysis. Results: A total of 112 patients (64 men, 48 women; median age, 58 years) were evaluated. Forty-two patients (37.5{\%}) developed POPF and 20 (17.9{\%}) developed high-grade POPF (grades B and C). Lower pancreatic stiffness (1.43 kPa; odds ratio [OR], 9.196; 95{\%} confidence interval [CI]: 1.92, 43.98), nondilated main pancreatic duct (MPD) diameter (,3 mm; OR, 7.298; 95{\%} CI: 1.51, 35.34), and larger stump area (211 mm2; OR, 9.210; 95{\%} CI: 1.53, 55.26) were risk factors for POPF. Lower pancreatic stiffness (1.27 kPa; OR, 8.389; 95{\%} CI: 1.88, 37.41) was the only independent predictor of high-grade POPF. Log-transformed pancreatic stiffness was independently associated with fibrosis (b = 0.060; 95{\%} CI: 0.052, 0.068), acinar atrophy (b = 0.015; 95{\%} CI: 0.003, 0.028), and lipomatosis (b = 20.016; 95{\%} CI: 20.026, 20.006). Conclusion: Preoperative MR assessment of pancreatic stiffness, MPD diameter, and stump area are important predictors of POPF.",
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T1 - Pancreatic stiffness quantified with MR elastography

T2 - Relationship to postoperative pancreatic fistula after pancreaticoenteric anastomosis

AU - Shi, Yu

AU - Liu, Ying

AU - Gao, Feng

AU - Liu, Yanqing

AU - Tao, Shengzhen

AU - Li, Yue

AU - Glaser, Kevin J.

AU - Ehman, Richard Lorne

AU - Guo, Qiyong

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Purpose: To describe the relationship between conventional magnetic resonance (MR) imaging parameters and MR elastography of the pancreas in association with pancreatic histologic features and occurrence of postoperative pancreatic fistula (POPF). Materials and Methods: Patients who underwent preoperative MR imaging (MR elastography and diffusion-, T1-, and T2-weighted imaging) followed by pancreatectomy with pancreaticoenteric anastomosis were included. The relationships between preoperative MR imaging parameters, demographic data, and intraoperative factors with POPF risk were analyzed with logistic regression analyses. The correlation of MR imaging parameters with histologic characteristics was evaluated with multivariate regression analysis. Results: A total of 112 patients (64 men, 48 women; median age, 58 years) were evaluated. Forty-two patients (37.5%) developed POPF and 20 (17.9%) developed high-grade POPF (grades B and C). Lower pancreatic stiffness (1.43 kPa; odds ratio [OR], 9.196; 95% confidence interval [CI]: 1.92, 43.98), nondilated main pancreatic duct (MPD) diameter (,3 mm; OR, 7.298; 95% CI: 1.51, 35.34), and larger stump area (211 mm2; OR, 9.210; 95% CI: 1.53, 55.26) were risk factors for POPF. Lower pancreatic stiffness (1.27 kPa; OR, 8.389; 95% CI: 1.88, 37.41) was the only independent predictor of high-grade POPF. Log-transformed pancreatic stiffness was independently associated with fibrosis (b = 0.060; 95% CI: 0.052, 0.068), acinar atrophy (b = 0.015; 95% CI: 0.003, 0.028), and lipomatosis (b = 20.016; 95% CI: 20.026, 20.006). Conclusion: Preoperative MR assessment of pancreatic stiffness, MPD diameter, and stump area are important predictors of POPF.

AB - Purpose: To describe the relationship between conventional magnetic resonance (MR) imaging parameters and MR elastography of the pancreas in association with pancreatic histologic features and occurrence of postoperative pancreatic fistula (POPF). Materials and Methods: Patients who underwent preoperative MR imaging (MR elastography and diffusion-, T1-, and T2-weighted imaging) followed by pancreatectomy with pancreaticoenteric anastomosis were included. The relationships between preoperative MR imaging parameters, demographic data, and intraoperative factors with POPF risk were analyzed with logistic regression analyses. The correlation of MR imaging parameters with histologic characteristics was evaluated with multivariate regression analysis. Results: A total of 112 patients (64 men, 48 women; median age, 58 years) were evaluated. Forty-two patients (37.5%) developed POPF and 20 (17.9%) developed high-grade POPF (grades B and C). Lower pancreatic stiffness (1.43 kPa; odds ratio [OR], 9.196; 95% confidence interval [CI]: 1.92, 43.98), nondilated main pancreatic duct (MPD) diameter (,3 mm; OR, 7.298; 95% CI: 1.51, 35.34), and larger stump area (211 mm2; OR, 9.210; 95% CI: 1.53, 55.26) were risk factors for POPF. Lower pancreatic stiffness (1.27 kPa; OR, 8.389; 95% CI: 1.88, 37.41) was the only independent predictor of high-grade POPF. Log-transformed pancreatic stiffness was independently associated with fibrosis (b = 0.060; 95% CI: 0.052, 0.068), acinar atrophy (b = 0.015; 95% CI: 0.003, 0.028), and lipomatosis (b = 20.016; 95% CI: 20.026, 20.006). Conclusion: Preoperative MR assessment of pancreatic stiffness, MPD diameter, and stump area are important predictors of POPF.

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