| Purpose:Pancreatic diseases in aggregate,including primary cancers,cystic lesions,and acute or chronic pancreatitis,affect>10%of the world’s population,imposing significant burdens on health care systems worldwide.Magnetic resonance elastography(MRE)is a newly emergent magnetic resonance-based functional technique for quantifying mechanical properties of tissues in vivo.In a number of pancreatic diseases,particularly those involving solid tumors,fibrosis,and inflammation,pancreatic stiffness is significantly altered.In order to accurately measure abnormal pancreatic stiffness values,a range of normal pancreatic stiffness values must firstly be established.At present,there are few studies on the application of MRE in pancreatic diseases,and the range of pancreatic stiffness values in large-scale populations is still in a blank field.In addition,the effects of epidemiological factors such as age,gender,body mass index(BMI),smoking,alcohol abuse,and diabetes mellitus(DM)on MRE-based pancreatic stiffness values are unknown.The purpose of our study was to measure the range of MRE-based pancreatic stiffness values in volunteers and explore the effect of epidemiological factors on pancreatic stiffness values..Methods:A total of 361volunteers(men,199;women,162)with a median age of 54.0years and a median BMI of 22.86 kg/m~2were prospectively recruited between December2016 and November 2018.Those with no histories of smoking,alcohol abuse,and diabetes mellitus(DM)were grouped as healthy volunteers,designating all others as positive controls.Each volunteer underwent conventional MRI of the pancreas and 3.0-T MRE at a frequency of 40 Hz.Epidemiological information such as age,gender,BMI,smoking,alcohol abuse,and DM was collected,and subjects’pancreatic stiffness values,pancreatic width and volume,waist circumference,and wave distance were measured.Multiple linear regression analyses were performed to determine variables that influence MRE-determined stiffness.Results:The mean pancreatic stiffness in all volunteers was 1.20±0.16 k Pa,with median value of 1.192(IQR:1.080-1.310 k Pa;range:0.84-1.70 k Pa).Stiffness levels in positive control volunteers proved significantly greater than levels in healthy volunteers(1.29±0.17 k Pa vs 1.14±0.13k Pa;P<0.001).In the healthy group,in terms of gender,mean pancreatic stiffness in men significantly exceeded that in women(1.18 k Pa vs 1.12k Pa;P=0.002).In terms of BMI,Although pancreatic stiffness at lower BMI levels(<24kg/m~2and 24-30 kg/m~2)did not differ significantly(P=0.298),both subsets differed significantly from the highest BMI group(P=0.030 and P=0.007,respectively).In terms of age,pancreatic stiffness beyond age 75 was significantly less than in the other age groups(<25 years:P=0.046;25-60 years:P=0.002 60-75 years:P=0.003).Mean A-P width peaked in years 25-60 and declined thereafter(1.83 cm,1.86 cm,1.73 cm,and1.56 cm,respectively;P<0.001),as did pancreatic volume(63.74 cm~3,70.23 cm~3,58.76cm~3,and 45.22 cm~3,respectively;P<0.001).In the positive group,smokers displayed significantly greater stiffness than non-smokers(1.31±0.17 k Pa vs 1.16±0.14 k Pa;P<0.001).Alcohol abuse(1.32±0.20 k Pa vs 1.18±0.14 k Pa;P<0.001)and diabetes(1.28±0.16 vs 1.19±0.13 k Pa;P=0.001)also increased pancreatic stiffness significantly.In multiple linear regression analysis,sex(P=0.004),BMI(P<0.001),pancreatic width(P=0.005),smoking(P<0.001),alcohol abuse(P<0.001)and DM(P=0.001)emerged as significant independent factors impacting pancreatic stiffness.Smoking,alcohol abuse,DM and wide pancreas were associated with greater pancreatic stiffness(coefficient=0.202,0.183,0.149 and 0.160,respectively)while reduced pancreatic stiffness corresponding with female sex and larger BMI(coefficient=-0.155 and-0.192,respectively).Conclusion:MRE-based pancreatic stiffness values is impacted by sex,BMI,pancreatic width,smoking,alcohol abuse and DM.Reference values are essential for future clinical studies. |
PDF Full Text Request