Pancreatic volume change using three dimensional-computed tomography volumetry and its relationships with diabetes on longterm follow-up in autoimmune pancreatitis  

作　　者：Ryuichi Shimada Yasunari Yamada Kazuhisa Okamoto Kazunari Murakami Mitsuteru Motomura Hajime Takaki Kengo Fukuzawa Yoshiki Asayama 

机构地区：[1]Department of Radiology,Oita University Faculty of Medicine,Yufu 879-5593,Oita,Japan [2]Department of Radiology,Oita Red Cross Hospital,Oita 870-0033,Oita,Japan [3]Department of Gastroenterology,Oita University Faculty of Medicine,Yufu 879-5593,Oita,Japan [4]Department of Hepato-Biliary-Pancreatic Internal Medicine,Oita Red Cross Hospital,Oita 870-0033,Oita,Japan [5]Department of Surgery,Oita Red Cross Hospital,Oita 870-0033,Oita,Japan

出　　处：《World Journal of Radiology》2024年第11期644-656,共13页世界放射学杂志（英文）

摘　　要：BACKGROUND Several studies found that early pancreatic atrophy detected by computed tomo-graphy(CT)within 6 months was associated with a high incidence of diabetes in patients with type-1 autoimmune pancreatitis(AIP)receiving steroid therapy;however,no long-term follow-up studies have been performed.AIM To investigate pancreatic volume(PV)changes using three dimensional(3D)-CT volumetry and their relationship with IgG4 and diabetes in patients with AIP.METHODS This retrospective study included 33 patients with type-1 AIP receiving steroid therapy.Patients were divided into diffuse(D-type)and mass-forming type(M-type)AIP.PV was determined by semi-automated 3D-CT volumetry,and changes between initial and follow-up values were calculated.The relationship between PV and serum IgG4 levels was analyzed by Spearman’s rank correlation.The PV atrophy ratio compared with the presumed normal PV at the time of last follow-up CT and its relationship with diabetes were investigated.RESULTS There were 16 D-type and 17 M-type patients with long-term follow-up(mean,95.8 months).The regression curve of mean relative PV change reduced exponentially and rapidly during the first 25 months and then more slowly in both groups.The overall cumulative pancreas re-enlargement rates at 1,3,5,7 and 10 years were 6.1%,12.2%,29.2%,47.5%and 55.0%,respectively.There was a moderate-to-very strong positive correlation(ρ≥0.4)between PV and serum IgG4 levels in nine(9/13,69.2%)patients.All 33 patients showed pancreatic atrophy(mean 59.3%)after long-term follow-up.Patients with D-type AIP had a significantly higher atrophy rate and higher incidence of diabetes than M-type patients(P<0.05).CONCLUSION PV change initially reduced exponentially and then more slowly and is considered an important factor associated with diabetes.Serum IgG4 levels were positively correlated with PV during follow-up.

关 键 词：Autoimmune pancreatitis Computerized tomography volumetry Follow-up study IGG4 DIABETES 

分 类 号：R657.5[医药卫生—外科学] R656.64[医药卫生—临床医学]