Diagnostic Value Of Magnetic Resonance Elastography And Intravoxel Incoherent Motion Diffusion Weighted Imaging In Staging Pancreatic Fibrosis

Objective: Pancreatic fibrosis is an important pathological process for the repair of pancreatic injury,but its diagnosis depends on postoperative pathology or endoscopic biopsy.Noninvasive imaging has developed rapidly in the diagnosis of pancreatic diseases,while MR elastography and Intravoxel incoherent motion diffusion weighted imaging have not been reported in the field of pancreatic fibrosis in China.This study aims to explore the diagnostic value of MRE and IVIM-DWI in the diagnosis of pancreatic fibrosis staging using the pathological results as the gold standard,and then.compare their diagnostic ability.Methods: This study was approved by the institutional review board with written informed consent.A total of 15 healthy volunteers and 42 patients(F0:8,F1:16,F2:11,F3:7)with pancreatic or ampullary masses and subsequent pancreaticoduodenectomy underwent preoperative 3-T MRE and IVIM DW imaging within less than one week.MRE and IVIM DW imaging parameters(stiffness,true diffusion coefficient [D],pseudodiffusion coefficient [D*],and perfusion fraction [f])were measured independently by two radiologists with more than 5 years of experience in abdominal imaging diagnosis.Spearman rank correlation coefficient were used to analyze the correlation between stiffness,D,D*,f values and pancreatic fibrosis.Receiver operating characteristic curve(ROC)analysis were to determine the diagnostic performance of MRE and IVIM parameters for staging pancreatic fibrosis degrees(F0–F3).Results: 1.The pancreatic stiffness,D,D*,f values were related statistically with pancreatic fibrosis(r=0.823,-0.399,-0.462,-0.586,respectively,all P<0.05).The pancreatic stiffness,D*,f values were statistically significant different(F=48.688,4.397,5.136,20.230,respectively,all P<0.05)in different pancreatic fibrosis.2.In the diagnosis of pancreatic fibrosis,moderate and severe pancreatic fibrosis,area under the curve stiffness value> f value> D *value> D value.3.In the diagnosis of pancreatic fibrosis,moderate and severe pancreatic fibrosis,the sensitivity and specificity of stiffness are better than f,D *,D values.Conclusion: MRE is an effective noninvasive method for the quantitative diagnosis of pancreatic fibrosis,IVIM parameters have a certain value in the diagnosis of pancreatic fibrosis,and f.value has a high diagnostic efficacy on the degree of pancreatic fibrosis.In the diagnosis of pancreatic fibrosis,moderate and severe pancreatic fibrosis,the stiffness value is superior to the f,D * and D values.In the diagnosis of pancreatic fibrosis,the stiffness value is superior to the f value with high sensitivity and specificity,which is expected to be a sensitive early predictor and follow-up method of pancreatic fibrosis.