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Healthy pancreatic parenchymal volume and its relationship to exocrine function

Abstract

Background

Pancreatic atrophy as a finding of chronic pancreatitis has largely been a subjective finding. Cross-sectional imaging should provide a means to quantify pancreatic atrophy.

Objective

The purposes of this study were to: (1) quantify pancreatic volume by magnetic resonance imaging (MRI) in a cohort of children without pancreatic disease, (2) define predictors of pancreatic volume and (3) assess the relationship between pancreatic volume and pancreatic fluid secretion.

Materials and methods

This study involved further analysis of data collected as part of an institutional review board-approved prospective study of secreted fluid volume in response to secretin in 50 healthy children ages 6–16 years. The pancreas was manually segmented on axial MR images to calculate pancreatic volume. Pearson correlation or the Student’s t-test were used to define associations between pancreatic volume and patient characteristics and previously calculated secreted fluid volume. Quantile regression was used to define the 5th percentile for pancreatic volume based on body surface area (BSA) [1].

Results

Mean pancreatic volume was 46.0±18.8 mL with no significant difference based on sex (boys: 42.4±19 mL, girls: 49.1±18.3 mL, P=0.21). Pancreatic volume was moderately correlated with age (r=0.51, P=0.002) and strongly correlated with BSA (r=0.75, P<0.0001), with the 5th percentile for pancreatic volume defined by: (24.66×BSA) – 4.97. Pancreatic volume was moderately correlated with volume of fluid secreted after secretin administration (r=0.51, P=0.0002).

Conclusion

We report increasing pancreatic volumes by MRI during childhood in a cohort of children without pancreatic disease. We have also shown that pancreatic volume is associated with secreted fluid volume as measured by MRI.

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Acknowledgments

We acknowledge the support of Rebecca Imbus and Tyler Thompson for their help with conducting the study. Funding was received from the National Pancreas Foundation with in-kind support from ChiRhoClin, Inc.

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Correspondence to Andrew T. Trout.

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McCleary, B.M., Trout, A.T., Fei, L. et al. Healthy pancreatic parenchymal volume and its relationship to exocrine function. Pediatr Radiol (2020). https://doi.org/10.1007/s00247-019-04605-z

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Keywords

  • Children
  • Exocrine insufficiency
  • Image segmentation
  • Magnetic resonance imaging
  • Pancreas
  • Pancreatitis
  • Secretin
  • Volume