Correlation of Pancreatic T1 Values Using Modified Look-Locker Inversion Recovery Sequence (MOLLI) with Pancreatic Exocrine and Endocrine Function.

Norihiro Ashihara,Akira Yamada,Makiko Ozawa,Yoko Usami,Keita Kanai,Satoko Kako,Takeji Umemura,Yasuhiro Kuraishi,Takayuki Watanabe,Shohei Shigefuji,Yasunari Fujinaga

doi:10.3390/jcm9061805

Abstract

Quantifying myocardial T1 values has been useful for detecting and characterizing fibrotic appearance in myocardial infarction, focal scars, and non-ischemic cardiomyopathies. Since pancreatic exocrine function decreases with chronic pancreatic fibrosis advancement, this study examined the correlation between pancreatic T1 values and pancreatic exocrine and endocrine insufficiency. Methods: Thirty-two patients underwent abdominal contrast-enhanced MRI in our department between October 2017 and February 2019. We evaluated the T1 values of the pancreas using a modified Look-Locker inversion recovery sequence (MOLLI), pancreatic exocrine insufficiency (PEI) by fecal elastase 1 (FE1) values, and pancreatic endocrine insufficiency using fasting insulin and blood glucose levels to calculate the HOMA-β. This trial is registered in the UMIN Clinical Trials Registry as UMIN 000030067. Results: The median cohort (9 males and 23 females) age was 71 (range: 49–84) years. Eighteen patients had pancreatic cysts, three had alcohol-induced chronic pancreatitis, three had pancreatic cancer, and eight possessed other pancreatic features (two patients each with autoimmune pancreatitis, acute pancreatitis, or a bile duct tumor, one with idiopathic chronic pancreatitis, and one healthy control with negative findings). The median pancreatic T1 value measured by the MOLLI was 857.5 ms (597–2569). A significant negative correlation was found between the T1 mapping and FE1 values (r = 0.69, p < 0.01), with none for the T1 with HOMA-β or serum albumin, triglycerides, or body mass index. Conclusions: the pancreatic T1 values correlated significantly with pancreatic exocrine function and might be useful in PEI diagnosis.

Highlights

Pancreatic exocrine dysfunction is often encountered in patients with advanced pancreatic fibrosis, detecting abnormalities in the absence of an advanced disease status or other symptoms is difficult
As pancreatic function decreases with chronic pancreatic fibrosis advancement, this study aimed to clarify the correlations between pancreatic T1 values and exocrine and endocrine insufficiency
To evaluate pancreatic endocrine function, the HOMA-β was measured in 30 cases after the exclusion of 2 cases which were subcutaneously administered insulin

Summary

Introduction

Pancreatic exocrine dysfunction is often encountered in patients with advanced pancreatic fibrosis, detecting abnormalities in the absence of an advanced disease status or other symptoms is difficult. The prompt diagnosis of asymptomatic pancreatic exocrine dysfunction is important. The long-term follow-up of pancreatic cystic neoplasms [2,3] and autoimmune pancreatitis [4,5] requires the diagnosis of pancreatic exocrine dysfunction, since these diseases cause pancreatic fibrosis and impaired exocrine function, similar to those in chronic pancreatitis. The life expectancy of patients with pancreatic exocrine dysfunction is approximately 15–20 years less than that of healthy individuals [8,14]

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