Pernille Lykke Andersen1, Adnan Madzak1, Søren Schou Olesen2,3, Asbjørn Mohr Drewes2,3, Jens Brøndum Frøkjaer1,3. 1. a Imaging Research Unit and Mech-Sense, Department of Radiology , Aalborg University Hospital , Aalborg , Denmark. 2. b Centre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology , Aalborg University Hospital , Aalborg , Denmark. 3. c Department of Clinical Medicine , Aalborg University , Aalborg , Denmark.
Abstract
OBJECTIVES: Parenchymal calcifications are considered a hallmark finding of chronic pancreatitis (CP), but little is known about its relation to the clinical presentation and other morphological features such as atrophy, fibrosis and ductal changes. The aim was to quantify the number and maximal size of parenchymal calcifications assessed on computed tomography (CT) and to explore the association with other CT and magnetic resonance imaging (MRI)-based pancreatic features and clinical parameters. METHODS: A well-characterised cohort of 54 CP patients was included. CT measurements included number and size of parenchymal calcifications, gland diameter and ductal diameter. MRI measurements included gland volume, ductal diameter, fibrosis (diffusion) and fatty infiltration (Dixon). Clinical parameters included body mass index (BMI), CP duration and aetiology, M-ANNHEIM clinical stage, tobacco use, alcohol consumption, the presence of diabetes, faecal elastase, clinical pain score and quality of life. RESULTS: There were no correlations between the number and size of parenchymal calcifications and any of the other morphological CT and MRI parameters (all p > .05), except for larger size of calcifications in patients with high number of calcifications (p < .001). The number of parenchymal calcifications was negatively correlated with BMI (r = -0.35, p = .0088). The number and size of parenchymal calcifications did not correlate with any of the other clinical parameters (all p > .2). CONCLUSION: Our findings could indicate the existence of parenchymal calcifications as an independent pathophysiological process involved in the development of CP. Translational impact: Quantifications of calcifications could, in combination with other imaging biomarkers, be a useful imaging marker relevant for characterising CP.
OBJECTIVES: Parenchymal calcifications are considered a hallmark finding of chronic pancreatitis (CP), but little is known about its relation to the clinical presentation and other morphological features such as atrophy, fibrosis and ductal changes. The aim was to quantify the number and maximal size of parenchymal calcifications assessed on computed tomography (CT) and to explore the association with other CT and magnetic resonance imaging (MRI)-based pancreatic features and clinical parameters. METHODS: A well-characterised cohort of 54 CP patients was included. CT measurements included number and size of parenchymal calcifications, gland diameter and ductal diameter. MRI measurements included gland volume, ductal diameter, fibrosis (diffusion) and fatty infiltration (Dixon). Clinical parameters included body mass index (BMI), CP duration and aetiology, M-ANNHEIM clinical stage, tobacco use, alcohol consumption, the presence of diabetes, faecal elastase, clinical pain score and quality of life. RESULTS: There were no correlations between the number and size of parenchymal calcifications and any of the other morphological CT and MRI parameters (all p > .05), except for larger size of calcifications in patients with high number of calcifications (p < .001). The number of parenchymal calcifications was negatively correlated with BMI (r = -0.35, p = .0088). The number and size of parenchymal calcifications did not correlate with any of the other clinical parameters (all p > .2). CONCLUSION: Our findings could indicate the existence of parenchymal calcifications as an independent pathophysiological process involved in the development of CP. Translational impact: Quantifications of calcifications could, in combination with other imaging biomarkers, be a useful imaging marker relevant for characterising CP.
Entities:
Keywords:
Chronic pancreatitis; calcification; computed tomography; magnetic resonance imaging; morphology
Authors: Christopher E Forsmark; Dana K Andersen; John T Farrar; Megan Golden; Aida Habtezion; Sohail Z Husain; Liang Li; Julia Mayerle; Stephen J Pandol; Aliye Uc; Zixi Zhu; Dhiraj Yadav Journal: Pancreas Date: 2018 Nov/Dec Impact factor: 3.327
Authors: Temel Tirkes; Zarine K Shah; Naoki Takahashi; Joseph R Grajo; Stephanie T Chang; Sudhakar K Venkatesh; Darwin L Conwell; Evan L Fogel; Walter Park; Mark Topazian; Dhiraj Yadav; Anil K Dasyam Journal: Radiology Date: 2018-10-16 Impact factor: 29.146