| Objective: To describe the relationship between conventional MR parameters and MR elastography of the pancreas in relationship to pancreatic histology and occurrence of postoperative pancreatic fistula(POPF).Method: Patients who underwent preoperative MR imaging(MR elastography,diffusion-,and T1-and T2-weighted imaging)followed by pancreatectomy and pancreatico-enteric anastomosis were included.The relationships between of preoperative MR parameters(Main pancreatic duct,Stiffness by MRE,SI ratio on T1 W imaging,Apparent diffusion coefficient,Pancreatic thickness,Pancreas-to-duct ratio,Stump area and Remnant volume),demographic data(Age,Sex,Body mass index,Diabetes mellitus History of weight loss,History of jaundice,History of smoking and Alcohol abuse),and intraoperative factors(Anastomosis,Operative time,Blood loss,Pancreatic texture by surgeon's palpation,Stump mobilization and Main pancreatic duct)with POPF risk were analyzed by logistic regression analyses.The correlation of MR parameters with histological characteristics was evaluated by multivariate regression analysis.Result: 112 patients(64 men,48 women;median age,58 years)were evaluated.Fortytwo patients(37.5%)developed POPF and 20(17.9%)developed high-grade POPF(grades B&C).Lower pancreatic stiffness(?1.43 k Pa,odds ratio[OR]=9.196,95% confidence interval[CI]: 1.92,43.98),nondilated main pancreatic duct diameter(<3 mm,OR=7.298,95% CI:1.51,35.34)and larger stump area(?211 mm2,OR=9.210,95% CI:1.53,55.26)were risk factors for POPF.Lower pancreatic stiffness(?1.27 k Pa,OR=8.389,95% CI: 1.88,37.41)was the only independent predictor of high-grade POPF.Log-transformed pancreatic stiffness was independently associated with fibrosis(?=0.060,95%CI: 0.052,0.068),acinar atrophy(?=0.015,95%CI: 0.003,0.028),and lipomatosis(?=–0.016,95%CI: –0.026,–0.006).Conclusion: Preoperative MR assessment of pancreatic stiffness,main pancreatic duct diameter,and stump area are important predictors of POPF... |
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