胰腺前后径MRI定量诊断自身免疫性胰腺炎并鉴别急性胰腺炎
AIP组各径线及比值显著高于正常组，胰体、尾径线及比值显著高于AP组；联合三径线逻辑回归模型AUC 0.732，优于单独胰腺体积。结论认为径线测量是支持性而非独立诊断指标。
要点
- 胰体、尾前后径及与L1椎体横径比值有助于鉴别AIP与AP。
- 联合胰头、体、尾前后径的模型诊断效能优于单独胰腺体积。
- 胰腺体积在AIP与AP间无显著差异，不宜单独用于鉴别。
核心结论
- 胰体和胰尾前后径是鉴别AIP与AP有实用价值的辅助指标。
- 胰头、体、尾前后径联合模型的诊断效能高于单独胰腺体积。
- 上述定量测量宜作为支持性发现，而非独立诊断标准。
研究设计与样本
- 基于MRI数据测量胰头、体、尾前后径、胰腺体积及第一腰椎椎体横径。
- 采用ROC曲线分析各指标诊断AIP及鉴别AIP与AP的效能。
诊断标准与关键数值
- 诊断AIP的AUC：胰头前后径0.804，胰体0.773，胰尾0.818，三者与TDL1比值分别为0.786、0.727、0.810。
- 鉴别AIP与AP的AUC：胰头前后径0.597，胰体0.708，胰尾0.704，三者与TDL1比值分别为0.545、0.673、0.667。
- 胰头、体、尾前后径联合逻辑回归模型鉴别AIP与AP的AUC为0.732，显著高于单独胰腺体积。
临床应用与阅片要点
- 阅片时可测量胰体、尾前后径并计算与L1椎体横径比值，辅助AIP与AP鉴别。
- 避免仅凭胰腺体积增大诊断AIP，因AIP与AP间体积无显著差异。
- 径线测量结果应结合临床和其他影像征象综合判断，不作独立诊断依据。
局限性
- 仅纳入弥漫性AIP-1，结论可能不适用于局灶性AIP或其他亚型。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
OBJECTIVE: This study aimed to quantitatively analyze the anteroposterior diameter of pancreas (ADpancreas) based on magnetic resonance imaging (MRI) data, and to evaluate their clinical value in diagnosing autoimmune pancreatitis (AIP) and differentiating it from acute pancreatitis (AP).
MATERIALS AND METHODS: MRI data from 32 patients with clinically confirmed diffuse AIP-1 were retrospectively analyzed. Thirty patients with AP and 32 individuals with normal pancreases were included as control groups. The anteroposterior diameters of the pancreatic head (ADhead), body (ADbody), and tail (ADtail), along with pancreatic volume and the transverse diameter of the first lumbar vertebral body (TDL1), were measured and compared across groups. Diagnostic performance was analyzed using receiver operating characteristic (ROC) curves.
RESULTS: ADhead, ADbody, ADtail, and their ratios to TDL1 were significantly higher in the AIP group compared to the normal pancreas group (P < 0.05). ADbody, ADtail, and their ratios to TDL1 were also significantly higher in the AIP group than in the AP group (P < 0.05). No statistically significant difference was observed in pancreatic volume between the AIP and AP groups (P > 0.05). The area under the ROC curve (AUC) for ADhead, ADbody, ADtail, and their ratios to TDL1 in diagnosing AIP were 0.804, 0.773, 0.818, 0.786, 0.727, and 0.810, respectively. In the differential diagnosis of AIP and AP, the AUCs for ADhead, ADbody and ADtail and their ratios to TDL1 were 0.597, 0.708, 0.704, 0.545, 0.673, and 0.667, respectively. A logistic regression model incorporating ADhead, ADbody, and ADtail yielded an AUC of 0.732, which was significantly higher than that of pancreatic volume alone.
CONCLUSION: ADbodyand ADtail are valuable and practical adjunctive indicators for differentiating AIP from AP. The combination of ADhead, ADbody, and ADtail demonstrates higher diagnostic efficiency than pancreatic volume alone. These quantitative measurements are best used as supportive findings rather than standalone diagnostic criteria.
引用
- Sun Z, Zhu X, Zhang N, et al. Anteroposterior diameter of the pancreas in the diagnosis of autoimmune pancreatitis and acute pancreatitis on MRI. Abdom Radiol (NY). 2026. PMID: 41973201. doi:10.1007/s00261-026-05493-2
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。