Cystic Fibrosis in Adolescents and Adults: Fatty Replacement of the Pancreas—CT Evaluation and Functional Correlation

Soyer, Philippe; Spelle, Laurent; Pelage, Jean-Pierre; Dufresne, Anne-Charlotte; Rondeau, Y; Gouhiri, M; Scherrer, Antoine; Rymer, Roland

doi:10.1148/radiology.210.3.r99mr08611

Cited by 75 publications

(45 citation statements)

References 20 publications

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“…However, no significant differences in the diameter of the pancreatic duct were found between the two groups at baseline or in the body or the tail of the pancreas. The clear difference in the size of the pancreas is in accordance with earlier observations [19]. The size of the pancreas in PS CF patients matched that of healthy persons and atrophy in PI CF group was not as severe as described by Soyer et al [19].…”

Section: Discussionsupporting

confidence: 92%

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Secretin-enhanced Magnetic Resonance Cholangiopancreatography in Pancreatic Insufficient and Pancreatic Sufficient Cystic Fibrosis Patients

Jończyk‐Potoczna

Nowak

Mądry

et al. 2016

JGLD

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Background & Aims: Although indirect methods of assessment of the exocrine pancreatic function have become the standard of care in the monitoring of pancreatic status, it still remains a current clinical challenge. Our aim was to compare the width of the pancreatic duct in pancreatic insufficient (PI) and pancreatic sufficient (PS) cystic fibrosis (CF) patients using secretin-enhanced magnetic resonance cholangiopancreatography (SE-MRCP). Methods: Thirty-seven CF patients were enrolled for this cross-sectional study, including 21 PI and 16 PS, all of whom underwent SE-MRCP. Measurement of the diameter of the pancreatic duct was performed in the head, body, and the tail of the pancreas at the baseline and after 1, 2, 3, 5, and 10 minutes after secretin administration. Results: The diameter of the pancreatic duct in the head of the pancreas after 5 and 10 minutes of secretin injection was greater in PI than in PS patients (median = 2.0 mm [interquartile range: 1.6-3.0] vs. 2.0 mm [1.0-2.0] and 2.0 mm [1.4-2.0] vs 1.0 mm [1.0-2.0], p=0.047 and p=0.040, respectively). Areas under ROC curves for discriminating between PI and PS patients were 0.693 (95% CI 0.521-0.866) and 0.698 (95% CI 0.528-0.868), respectively. No other differences in the width of the duct were identified at the baseline or during SE-MRCP. Conclusions: The measurement of the diameter of the pancreatic duct during secretin stimulation does not allow for differentiating between PS and PI status in CF patients. Abbreviations: CF: cystic fibrosis; CFTR: cystic fibrosis transmembrane conductance regulator; ELISA: enzyme-linked immunosorbent assay; ERCP: endoscopic retrograde cholangiopancreatography; E1: elastase-1; MRI: magnetic resonance imaging; PI: pancreatic insufficient; PS: pancreatic sufficient; SCT gene: secretin gene; SE-MRCP: secretin-enhanced magnetic resonance cholangiopancreatography; T: tesla; TR: repetition time; TE: echo time.

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Section: Discussionsupporting

confidence: 92%

“…The clear difference in the size of the pancreas is in accordance with earlier observations [19]. The size of the pancreas in PS CF patients matched that of healthy persons and atrophy in PI CF group was not as severe as described by Soyer et al [19]. It highlights the extent of damage to the pancreatic parenchyma that may be caused by CF.…”

Section: Discussionsupporting

confidence: 91%

Secretin-enhanced Magnetic Resonance Cholangiopancreatography in Pancreatic Insufficient and Pancreatic Sufficient Cystic Fibrosis Patients

Jończyk‐Potoczna

Nowak

Mądry

et al. 2016

JGLD

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“…Post-mortem analyses and in vivo imaging of the pancreas of CF patients have shown that the pancreas is significantly reduced in size in patients with CF [21], and that pancreatic fatty replacement is the most commonly found pattern on CT and MRI [20,22]. Therefore, prior to the beginning of our study, we anticipated that the volume of the pancreas of CF patients would differ from that of healthy individuals and that the volume loss would be greater in CFRD patients.…”

Section: Discussionmentioning

confidence: 99%

“…MRI is also superior to ultrasound examinations for analysis of the pancreas because it allows precise differentiation between intra-and peripancreatic fat. This is not always possible when ultrasound is used: a falsely enlarged pancreatic volume may be measured if extra-pancreatic regions that have been replaced by fat are included in addition to true pancreatic tissue [20].…”

Section: Discussionmentioning

confidence: 99%

MRI appearance of the pancreas in patients with cystic fibrosis: a comparison of pancreas volume in diabetic and non-diabetic patients

Sequeiros

Hester²,

Callaway³

et al. 2010

BJR

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ABSTRACT. We investigated differences in the volume of the pancreas in cystic fibrosis (CF) patients with and without diabetes using MRI to study the natural history of CFrelated diabetes (CFRD). We investigated 29 pancreas-insufficient adult CF patients, 13 with CFRD and 16 without diabetes. Patients with CFRD were receiving insulin therapy at the time of study. None of the non-diabetic CF patients had evidence of impaired glucose tolerance. Pancreas volume was estimated by MRI scans using T 1 weighted fatsuppression sequences and assessed by an examiner who was unaware of the patients' diabetes status. Pancreas volume of CF patients was measured and subsequently compared with that of non-CF age-matched Type 1 diabetes (T1DM) patients and healthy controls previously investigated. The two CF groups were matched for age and gender. There were no differences in spirometry values, body mass index or pancreatic exocrine function. The pancreas was visible by MRI in only 3 of 13 (23.1%) patients with CFRD and in 5 of 16 (31.3%) patients without diabetes (p-value50.7). In total, the pancreas was not detected by MRI as an anatomical entity in 21 of 29 (72.4%) CF patients, irrespective of their diabetes status. When comparing the four study groups, the pancreas was significantly smaller in CF patients than in T1DM patients and healthy controls.

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“…Outros padrões descritos são o aumento pancreático por pseudo-hipertrofia lipomatosa, completa atrofia pancreática sem lipossubstituição, fibrose pancreática difusa ou transformação cística (2) . Dentre as principais causas de lipossubstituição pancreática devemos considerar a síndrome de Cushing, o uso prolongado de corticosteróides, a desnutrição grave, a síndrome de Shwachman, a hemocromatose e a infecção virótica (6) .…”

Section: Pancreáticaunclassified

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Teixeira¹,

Matos²,

Melo³

et al. 2006

Radiol Bras

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Cystic Fibrosis in Adolescents and Adults: Fatty Replacement of the Pancreas—CT Evaluation and Functional Correlation

Abstract: In patients with CF, pancreatic glandular tissue is significantly reduced in size. Pancreatic fatty replacement is the most frequent pattern in older patients with CF and correlates with pancreatic exocrine dysfunction.

Cited by 75 publications

References 20 publications

Secretin-enhanced Magnetic Resonance Cholangiopancreatography in Pancreatic Insufficient and Pancreatic Sufficient Cystic Fibrosis Patients

Secretin-enhanced Magnetic Resonance Cholangiopancreatography in Pancreatic Insufficient and Pancreatic Sufficient Cystic Fibrosis Patients

MRI appearance of the pancreas in patients with cystic fibrosis: a comparison of pancreas volume in diabetic and non-diabetic patients

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