The pancreas-to-muscle signal intensity ratio on T 1 -weighted MRI as a predictive biomarker for postoperative pancreatic fistula after distal pancreatectomy: a single-center retrospective study
World Journal of Surgical Oncology(2022)
摘要
Background Postoperative pancreatic fistula (POPF) is one of the serious complications of pancreatic surgery. When POPF occurs and becomes severe, it causes secondary complications and a longer treatment period. We previously reported a correlation between pancreatic fibrosis and magnetic resonance imaging (MRI) findings, and MRI may have the potential to predict POPF. This study aimed to assess the predictive ability of the pancreas-to-muscle signal intensity ratio on T 1 -weighted MRI (SIR on T 1 -w MRI) for POPF after distal pancreatectomy (DP). Methods This single-institution retrospective study comprised 117 patients who underwent DP. It was conducted between 2010 and 2021 at the Gifu University Hospital. We statistically analyzed pre-, intra-, and postoperative factors to assess the correlation with POPF. Results According to the definition and grading of the International Study Group of Pancreatic Fistula (ISGPF), 29 (24.8%) of the 117 patients had POPF grades B and C. In the univariate analysis, POPF was significantly associated with the pancreas-to-muscle SIR on T 1 -w MRI, the drainage fluid amylase concentration (D-Amy) levels on postoperative day (POD) 1 and 3, white blood cell count on POD 1 and 3, C-reactive protein level on POD 3, and heart rate on POD 3. In multivariate analysis, only the pancreas-to-muscle SIR on T 1 -w MRI (>1.37; odds ratio [OR] 23.25; 95% confidence interval [CI] 3.93–454.03; p < 0.01) and D-Amy level on POD 3 (>737 U/l; OR 3.91; 95% CI 1.02–16.36; p = 0.046) were identified as independent predictive factors. Conclusions The pancreas-to-muscle SIR on T 1 -w MRI and postoperative D-Amy levels were able to predict the development of POPF after DP. The pancreas-to-muscle SIR on T 1 -w MRI may be a potential objective biomarker reflecting pancreatic status.
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关键词
Signal intensity ratio on T1-weighted MRI, Postoperative pancreatic fistula, Distal pancreatectomy
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