論文

査読有り 国際誌
2021年10月12日

Estimation of pancreatic fibrosis and prediction of postoperative pancreatic fistula using extracellular volume fraction in multiphasic contrast-enhanced CT.

European radiology
  • Keitaro Sofue
  • ,
  • Eisuke Ueshima
  • ,
  • Atsuhiro Masuda
  • ,
  • Sachiyo Shirakawa
  • ,
  • Yoh Zen
  • ,
  • Yoshiko Ueno
  • ,
  • Yushi Tsujita
  • ,
  • Takeru Yamaguchi
  • ,
  • Shinji Yabe
  • ,
  • Takeshi Tanaka
  • ,
  • Noriko Inomata
  • ,
  • Hirochika Toyama
  • ,
  • Takumi Fukumoto
  • ,
  • Yuzo Kodama
  • ,
  • Takamichi Murakami

記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00330-021-08255-4

OBJECTIVE: To investigate the diagnostic performance of the extracellular volume (ECV) fraction in multiphasic contrast-enhanced computed tomography (CE-CT) for estimating histologic pancreatic fibrosis and predicting postoperative pancreatic fistula (POPF). METHODS: Eighty-five patients (49 men; mean age, 69 years) who underwent multiphasic CE-CT followed by pancreaticoduodenectomy with pancreaticojejunal anastomosis between January 2012 and December 2018 were retrospectively included. The ECV fraction was calculated from absolute enhancements of the pancreas and aorta between the precontrast and equilibrium-phase images, followed by comparisons among histologic pancreatic fibrosis grades (F0‒F3). The diagnostic performance of the ECV fraction in advanced fibrosis (F2‒F3) was evaluated using receiver operating characteristic curve analysis. Multivariate logistic regression analysis was used to evaluate the associations of the risk of POPF development with patient characteristics, histologic findings, and CT imaging parameters. RESULTS: The mean ECV fraction of the pancreas was 34.4% ± 9.5, with an excellent intrareader agreement of 0.811 and a moderate positive correlation with pancreatic fibrosis (r = 0.476; p < 0.001). The mean ECV fraction in advanced fibrosis was significantly higher than that in no/mild fibrosis (44.4% ± 10.8 vs. 31.7% ± 6.7; p < 0.001), and the area under the receiver operating characteristic curve for the diagnosis of advanced fibrosis was 0.837. Twenty-two patients (25.9%) developed clinically relevant POPF. Multivariate logistic regression analysis demonstrated that the ECV fraction was a significant predictor of POPF. CONCLUSIONS: The ECV fraction can offer quantitative information for assessing pancreatic fibrosis and POPF after pancreaticojejunal anastomosis. KEY POINTS: • There was a moderate positive correlation of the extracellular volume (ECV) fraction of the pancreas in contrast-enhanced CT with the histologic grade of pancreatic fibrosis (r = 0.476; p < 0.001). • The ECV fraction was higher in advanced fibrosis (F2‒F3) than in no/mild fibrosis (F0‒F1) (p < 0.001), with an AUC of 0.837 for detecting advanced fibrosis. • The ECV fraction was an independent risk factor for predicting subclinical (odds ratio, 0.81) and clinical (odds ratio, 0.80) postoperative pancreatic fistula.

リンク情報
DOI
https://doi.org/10.1007/s00330-021-08255-4
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/34636963
ID情報
  • DOI : 10.1007/s00330-021-08255-4
  • PubMed ID : 34636963

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