Pancreatic extracellular volume fraction on routine contrast-enhanced computed tomography can predict pancreatic fibrosis and postoperative pancreatic fistula.

IF 2.8 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology Pub Date : 2024-12-06 DOI:10.1016/j.pan.2024.12.003

Takahide Sasaki, Yukihisa Takayama, Shinji Tanaka, Yoshihiro Hamada, Ryo Nakashima, Shigetoshi Naito, Masatoshi Kajiwara, Suguru Hasegawa

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引用次数: 0

Abstract

Background/objectives: Postoperative pancreatic fistula (POPF) is a critical complication of pancreatectomy, with a higher risk associated with the absence of pancreatic fibrosis. We investigated whether pancreatic extracellular volume fraction (ECV) calculated from preoperative contrast-enhanced computed tomography (CE-CT) images can be used to predict pancreatic fibrosis and POPF.

Methods: This retrospective study included patients who underwent CE-CT before pancreatectomy. ECV map was created by subtracting unenhanced from equilibrium-phase images. We assessed the relationship between pancreatic ECV, the histopathological grade of fibrosis at the pancreatic resection margin, and the occurrence of POPF.

Results: Among the 107 patients included, 66 underwent pancreaticoduodenectomy (PD) and 41 underwent distal pancreatectomy (DP). The median ECV at the pancreatic resection margin was 22.5 %. Pancreatic ECV significantly correlated with the histopathological grade of pancreatic fibrosis (ρ = 0.689; p < 0.001). In PD cases, the ECV was an independent risk factor for all-grade POPF (odds ratio, 0.852; 95 % confidence interval, 0.755-0.934), with excellent predictive capability (area under the curve, 0.912; 95 % confidence interval, 0.842-0.983). In DP cases, pancreatic thickness was the only factor associated with all-grade POPF.

Conclusions: Pancreatic ECV obtained from routine CE-CT images accurately predicted the histopathological grade of pancreatic fibrosis and was an independent risk factor for POPF after PD.

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常规造影剂增强计算机断层扫描显示的胰腺细胞外体积分数可预测胰腺纤维化和术后胰瘘。

背景/目的：术后胰瘘（POPF）是胰腺切除术的一个重要并发症，与无胰腺纤维化相关的风险更高。我们研究了根据术前对比增强计算机断层扫描（CE-CT）图像计算的胰腺细胞外体积分数（ECV）是否可用于预测胰腺纤维化和胰瘘：这项回顾性研究纳入了在胰腺切除术前接受CE-CT检查的患者。通过从平衡相图像中减去未增强图像，绘制出ECV图。我们评估了胰腺 ECV、胰腺切除边缘纤维化的组织病理学分级和 POPF 发生率之间的关系：结果：在纳入的 107 例患者中，66 例接受了胰十二指肠切除术（PD），41 例接受了远端胰腺切除术（DP）。胰腺切除边缘的中位ECV为22.5%。胰腺ECV与胰腺纤维化的组织病理学分级有明显相关性（ρ = 0.689; p 结论：胰腺ECV与胰腺纤维化的组织病理学分级有明显相关性（ρ = 0.689; p）：通过常规 CE-CT 图像获得的胰腺 ECV 可准确预测胰腺纤维化的组织病理学分级，是胰腺癌术后 POPF 的独立危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pancreatology 医学-胃肠肝病学

CiteScore

7.20

自引率

5.60%

发文量

194

审稿时长

44 days

期刊介绍： Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.