Effects of diabetic ketoacidosis, islet cell function, and age of onset on pancreas size, morphology, and exocrine function in children with type 1 diabetes: an abdominal MRI study.

Objective: To investigate pancreatic MRI parameters changes in children with T1D and to assess the effects of DKA, islet cell function, and onset age on the pancreas size, morphology, and exocrine function.

Methods: 176 children with newly diagnosed T1D and 100 age- and sex-matched controls were enrolled in this retrospective study. Clinical metrics and pancreatic MRI parameters were collected and compared, and correlation analyses were performed to explore the relationships.

Results: Pancreas volume, pancreas volume index (PVI), pancreas body and tail diameters, pancreas surface area, pancreas tail-to-spleen signal ratio, and pancreatic border irregularity score were lower, and pancreas surface area-to-volume ratio was higher in the T1D group than in the control group. T1D-DKA subgroup had a lower pancreas tail-to-spleen signal ratio and pancreatic border irregularity score than T1D-diabetic ketosis (T1D-DK) subgroup. Subgroup with an onset age under 10 years had a lower pancreas volume, pancreas head, body, and tail diameters, and pancreas surface area than subgroup with an onset age of 10 years or older. Several pancreatic MRI indices correlated with C-peptide levels in the T1D group, T1D-DK subgroup, and T1D-DKA subgroup but not in the T1D-alone subgroup. The integrated assessment of pancreatic size, morphology, and MR signal characteristics more effectively distinguishes the pancreas of T1D children from that of controls when compared to evaluating these factors individually.

Conclusion: T1D affects the size, morphology and exocrine function of the pancreas in children, which is associated with DKA, islet cell function and onset age.