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Single- and multiparameter magnetic resonance imaging for diagnosing and severity grading of chronic pancreatitis

  • Pancreas
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

The study aimed to determine the performance of advanced magnetic resonance imaging (MRI), including a multiparametric MRI-index, for diagnosing and severity grading of chronic pancreatitis (CP) at various functional stages with focus on detection of CP with preserved pancreatic function.

Methods

Fifty-four CP patients and 35 healthy controls underwent MRI including assessment of pancreatic volume, main pancreatic duct (MPD) diameter, T1 relaxation time, magnetic resonance elastography (MRE) derived stiffness, and intravoxel incoherent motion (IVIM) diffusion-weighted imaging. Patients were categorized into three subgroups: Preserved pancreatic function (n = 14), partial pancreatic insufficiency (exocrine insufficiency or diabetes, n = 25), and complete pancreatic insufficiency (exocrine insufficiency and diabetes, n = 15). A multiparametric MRI-index was based on ordinal logistic regression analysis. Diagnostic performances of MRI parameters for diagnosing CP at different functional stages were determined using receiver operating characteristic (ROC) analysis.

Results

All MRI parameters differed across CP subgroups and healthy controls (all P < 0.001), except for IVIM. T1 relaxation time (ROC area under the curve (ROC-AUC) 0.82), MRE (ROC-AUC 0.88), and MRI-index (ROC-AUC 0.86) showed the highest performance for detecting patients with preserved pancreatic function (early CP) vs. healthy controls. For detecting preserved pancreatic function vs. partial insufficiency, pancreatic volume, MRI-index, and T1 relaxation time performed best (all ROC-AUC > 0.75), with the MRI-index tending to outperform MRE (ROC-AUC 0.77 vs. 0.63; P = 0.10).

Conclusion

Quantitative assessments of T1 relaxation time and MRE-derived stiffness seem promising for diagnosing CP at different functional stages and may together with multiparametric MRI-index be used for early identification, staging and monitoring of CP.

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Acknowledgements

The authors thank radiographer Kenneth Krogh Jensen for his assistance in data collection.

Funding

This research received no external funding.

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Authors and Affiliations

  1. Department of Gastroenterology & Hepatology, Centre for Pancreatic Diseases, Aalborg University Hospital, Mølleparkvej 4, 9000, Aalborg, Denmark

    Søren Schou Olesen, Emily Steinkohl & Asbjørn Mohr Drewes

  2. Department of Clinical Medicine, Aalborg University, Søndre Skovvej 11, 9000, Aalborg, Denmark

    Søren Schou Olesen, Emily Steinkohl, Tine Maria Hansen, Asbjørn Mohr Drewes & Jens Brøndum Frøkjær

  3. Mech-Sense, Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, PO. Box 365, 9000, Aalborg, Denmark

    Emily Steinkohl, Tine Maria Hansen & Jens Brøndum Frøkjær

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  1. Søren Schou Olesen
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Correspondence to Jens Brøndum Frøkjær.

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Olesen, S.S., Steinkohl, E., Hansen, T.M. et al. Single- and multiparameter magnetic resonance imaging for diagnosing and severity grading of chronic pancreatitis. Abdom Radiol 48, 630–641 (2023). https://doi.org/10.1007/s00261-022-03760-6

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  • DOI: https://doi.org/10.1007/s00261-022-03760-6

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