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Prediction of pancreatic atrophy after steroid therapy using equilibrium‐phase contrast computed tomography imaging in autoimmune pancreatitis
Author(s) -
Yamada Yasutaka,
Masuda Atsuhiro,
Sofue Keitaro,
Ueshima Eisuke,
Shiomi Hideyuki,
Sakai Arata,
Kobayashi Takashi,
Ikegawa Takuya,
Tanaka Shunta,
Nakano Ryota,
Tanaka Takeshi,
Kakihara Maya,
Ashina Shigeto,
Tsujimae Masahiro,
Yamakawa Kohei,
Abe Shohei,
Gonda Masanori,
Masuda Shigeto,
Inomata Noriko,
Kutsumi Hiromu,
Itoh Tomoo,
Murakami Takamichi,
Kodama Yuzo
Publication year - 2020
Publication title -
jgh open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 8
ISSN - 2397-9070
DOI - 10.1002/jgh3.12316
Subject(s) - autoimmune pancreatitis , medicine , atrophy , exacerbation , nuclear medicine , hounsfield scale , pancreatitis , pancreas , diabetes mellitus , radiology , gastroenterology , computed tomography , endocrinology
Background and Aims Imaging tools for predicting pancreatic atrophy after steroid therapy in autoimmune pancreatitis (AIP) have not been established. As delayed equilibrium‐phase contrast enhancement in computed tomography (CE‐CT) may reflect interstitial fibrosis, we evaluated the ability of equilibrium‐phase CT imaging for predicting pancreatic atrophy. Methods Forty‐six steroid‐treated AIP patients who underwent contrast‐enhanced CT at our university hospital were included in this retrospective study. CT attenuation (Hounsfield units [HU]) values in noncontrast images (NC) and equilibrium‐phase images (EP) and the differences in HU values between NC and EP images (SUB) were measured. Pancreatic volume was measured in CE‐CT before (Vol pre ) and after (Vol post ) steroid therapy. The volume reduction rate was calculated. The relationships of CT values with pancreatic atrophy, Vol post , volume reduction rate, and diabetes exacerbation were investigated. Results CT values in the EP and SUB images before steroid therapy were associated with pancreatic atrophy after steroid therapy (atrophy vs nonatrophy 114.5 ± 12.8 vs 99.5 ± 11.1, P = 0.0002; 70.9 ± 14.72 vs 57.2 ± 13.1, P = 0.003, respectively), but CT values in NC images were not ( P = 0.42). CT values in EP and SUB images before steroid therapy were correlated with Vol post (EP images r = −0.70, P = 0.002; SUB images r = −0.68, P = 0.03) and volume reduction rate after steroid therapy (EP images: r = −0.55, P < 0.0001; SUB images r = −0.45, P = 0.002). Diabetes exacerbation was associated with higher EP and SUB values ( P = 0.009 and P = 0.04, respectively). Conclusion Equilibrium‐phase contrast CT imaging may facilitate prediction of pancreatic atrophy after steroid therapy in AIP.

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