利用增强计算机断层扫描的细胞外体积分数评估胰腺组织学和术后胰瘘的可能性。

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

World Journal of Clinical Cases Pub Date : 2025-09-26 DOI:10.12998/wjcc.v13.i27.109243

Akihiro Nakamura, Takafumi Ogawa, Kuniya Tanaka, Yuki Takahashi, So Murai, Yuki Tashiro, Akane Wada, Yasuo Ueda, Yosuke Sasaki, Yuzo Minegishi, Kenichi Matsuo, Toshiko Yamochi

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引用次数: 0

摘要

背景：胰腺纤维化可降低术后胰瘘（POPF）的风险，可通过细胞外体积分数（ECVf）来评估。目的：探讨ECVf与胰腺组织学的相关性，以及ECVf在预测POPF中的应用价值。方法：在71例行胰腺切除术的患者中，我们通过比较对比前和平衡期胰腺和主动脉的绝对增强来计算胰腺ECVf。根据切除标本计算纤维化、脂肪、腺泡和胰岛的面积。结果：ECVf与纤维化相关（r = 0.724, P < 0.001），与acini负相关（r = -0.510, P < 0.001）。48例行胰十二指肠切除术的患者中，21例发生POPF。多因素分析选择主胰管直径≤2mm、ECVf < 36%为危险因素[各自优势比（OR）和P值分别为4.26和P = 0.048；OR = 11.07, P = 0.036]。使用这些因素作为风险评分（0-2分），分别有0%、50%和70%的患者发生POPF，分别为0分、1分和2分。结论：ECVf可用于预测腺泡损失和胰腺纤维化，ECVf < 36%可能是POPF的危险因素。

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Estimation of pancreatic histology and likelihood of postoperative pancreatic fistula using extracellular volume fraction from contrast-enhanced computed tomography.

Background: Pancreatic fibrosis, which decreases risk of postoperative pancreatic fistula (POPF), can be estimated using extracellular volume fraction (ECVf).

Aim: To investigate the correlation between ECVf and pancreatic histology, as well as the usefulness of ECVf in predicting POPF.

Methods: In 71 patients who underwent pancreatic resection, we caluculated pancreatic ECVf by comparing absolute enhancements of the pancreas and aorta between pre-contrast and equilibrium phases. Areas of fibrosis, fat, acini, and islets were calculated based on resection specimens.

Results: ECVf correlated with fibrosis (r = 0.724; P < 0.001) and negatively correlated with acini (r = -0.510; P < 0.001). Among 48 patients who underwent pancreatoduodenectomy, 21 developed POPF. Main pancreatic duct diameter ≤ 2 mm and ECVf < 36% were selected as risk factors by multivariate analysis [respective odds ratios (OR) and P values, 4.26 and P = 0.048; OR = 11.07 and P = 0.036]. Using these factors as a risk score (0-2 points), POPF occurred in 0%, 50%, and 70% of patients with 0, 1, and 2 points, respectively.

Conclusion: ECVf is useful in predicting acinar loss and pancreatic fibrosis, and ECVf < 36% may be a risk factor for POPF.

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来源期刊

World Journal of Clinical Cases Medicine-General Medicine

自引率

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发文量

3384

期刊介绍： The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.