Abstract
PurposeTo evaluate the association of the pancreatic exocrine function estimated by cine-dynamic magnetic resonance cholangiopancreatography (MRCP) using a spatially selective inversion-recovery (IR) pulse with the pancreatic endocrine function estimated by the T1 relaxation time of the pancreatic parenchyma and HbA1c values.Materials and methodsForty-three patients with suspected hepatobiliary or pancreatic diseases were included. Patients were classified into three groups: HbA1c < 5.7% (normal group), 5.7% ≤ HbA1c < 6.5% (prediabetes group), and HbA1c ≥ 6.5% (diabetes group). The frequency of the secretory flow of the pancreatic juice was observed within the area of the IR pulse, and the moving distance (mean secretion grade) of the pancreatic juice inflow within the area of the IR pulse on cine-dynamic MRCP, and the T1 relaxation time of the pancreatic parenchyma on the T1 map images were assessed. The MR imaging measurements were compared using Spearman’s rank correlation coefficient analysis and the Kruskal–Wallis and Mann–Whitney U tests.ResultsBoth the mean secretion grade and frequency of the pancreatic secretory inflow had a significant negative correlation with the T1 relaxation time of the pancreatic parenchyma (r = − 0.335, p = 0.028 and r = − 0.305, p = 0.047, respectively) and HbA1c values (r = − 0.308, p = 0.044 and r = − 0.313, p = 0.041, respectively). Both the mean secretion grade and frequency of the pancreatic secretory inflow in the elevated HbA1c (prediabetes and diabetes) group were significantly lower than those in the normal group (p = 0.030 and p = 0.029, respectively).ConclusionThe pancreatic exocrine function estimated by cine-dynamic MRCP was significantly lower in patients with prediabetes and diabetes than in controls. Cine-dynamic MRCP with a spatially selective IR pulse may be useful for the early diagnosis of pancreatic exocrine insufficiency in patients with pancreatic endocrine insufficiency.
Highlights
The endocrine and exocrine tissues of the pancreas reciprocally interact to coordinate the activities of digestion, absorption, and glucose metabolisms [1]
Our findings showed that both the mean secretion grade and frequency of the pancreatic secretory inflow in cine-dynamic magnetic resonance cholangiopancreatography (MRCP) with a spatially selective IR pulse had a significant negative correlation with the HbA1c values
A previous study demonstrated that the cut-off value of 0.7 for the mean secretion grade in cine-dynamic MRCP was the criterion of pancreatic exocrine dysfunction [6]
Summary
The endocrine and exocrine tissues of the pancreas reciprocally interact to coordinate the activities of digestion, absorption, and glucose metabolisms [1]. Impairment of the pancreatic endocrine function can cause pancreatic exocrine insufficiency. Diabetes mellitus (DM) is one of the most common endocrine disorders, resulting from insulin resistance and insulin deficiency and accompanied by an impaired exocrine function that manifests as an insufficient activity of digestive enzymes. Pancreatic exocrine insufficiency has been reported to be present in a considerable proportion of patients with DM (26%-74% of type 1 DM patients and 10%-56% of type 2 DM patients) [3]. Patients with pancreatic exocrine insufficiency often have symptoms including steatorrhea, abdominal pain, abdominal bloating and weight loss, mainly due to the maldigestion and malabsorption of fat Japanese Journal of Radiology (2022) 40:696–702
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