胰腺实质定量MRI与IPMN指南特征风险分层的关联
本研究纳入235名参与者（163例IPMN和72例正常胰腺），依据2024年国际共识指南将IPMN分为无指南特征组（111例）和有指南特征组（52例），分析胰腺定量MRI参数与风险分层的关联。结果显示T1弛豫时间在胰头和胰体尾均与IPMN风险分层独立相关，能显著区分有无指南特征的患者，可能作为有价值的影像生物标志物。
要点
- T1弛豫时间在胰头和胰体尾均与IPMN风险分层独立相关（p<0.001）。
- T1弛豫时间可区分正常胰腺与无/有指南特征的IPMN。
- 年龄和BMI也是IPMN风险分层的独立预测因素。
核心结论
- T1弛豫时间与IPMN风险分层显著相关，可能作为补充指南特征的影像生物标志物。
研究设计与样本
- 单中心研究纳入235名参与者：163例IPMN和72例正常胰腺，IPMN按2024国际共识指南分为无指南特征组（n=111）和有指南特征组（n=52）。
- MRI参数包括同相位、反相位和T2WI的胰腺-肌肉信号强度比、ADC、PDFF以及胰头、体、尾的T1和T2*弛豫时间；参考标准为指南特征分层。
- 统计方法采用Spearman秩相关及单因素和多因素logistic回归。
诊断标准与关键数值
- 多因素分析中，年龄、BMI和T1弛豫时间在胰头和胰体尾均为IPMN的独立预测因素。
- T1弛豫时间在胰头和胰体尾均能显著区分有无指南特征的患者（p<0.001）。
临床应用与阅片要点
- 阅片时可关注胰腺T1弛豫时间，尤其胰头和胰体尾区域，辅助IPMN风险分层。
- 结合年龄和BMI等临床信息综合评估IPMN风险。
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
OBJECTIVES: To investigate the association between quantitative MRI parameters of the pancreatic parenchyma and risk stratification of intraductal papillary mucinous neoplasm (IPMN).
MATERIALS AND METHODS: This study included 235 participants: 163 with IPMN and 72 with a normal pancreas. IPMN cases were stratified into IPMN without guideline-based features (n = 111) and with guideline-based features (n = 52) groups based on the 2024 International Consensus Guidelines. The MRI parameters analyzed included pancreas-to-muscle signal intensity ratios on in-phase, opposed-phase, and T2-weighted images; apparent diffusion coefficient (ADC); proton density fat fraction (PDFF); and T1 and T2* relaxation times in the pancreatic head, body, and tail. Clinical data (age, sex, body mass index (BMI), HbA1c, bilirubin, amylase, and CA19-9) were collected. Associations with IPMN risk stratification were evaluated using Spearman's rank correlation and univariate and multivariate logistic regression.
RESULTS: In the pancreatic head, IPMN risk stratification showed significant correlations with age (p < 0.001), BMI (p < 0.001), HbA1c (p = 0.024), ADC (p = 0.025), PDFF (p = 0.008), and T1 relaxation time (p < 0.001). In the body and tail, risk stratification correlated with age (p < 0.001), BMI (p = 0.004), and T1 relaxation time (p < 0.001). In multivariate analysis, age, BMI, and T1 relaxation time were independent predictors of IPMN in both regions. T1 relaxation time significantly distinguished patients with and without guideline-based features in both regions (p < 0.001).
CONCLUSION: T1 relaxation time is significantly associated with IPMN risk stratification and may serve as a valuable imaging biomarker.
KEY POINTS: Question Pancreatic fat content and fibrosis are potential imaging biomarkers, but their relationship to IPMN risk stratification has not been clearly established. Findings T1 relaxation time was independently associated with IPMN risk stratification, and T1 relaxation time differentiated normal pancreas from that with and without guideline-based features of IPMN. Clinical relevance MRI-derived T1 relaxation time demonstrates utility in IPMN risk stratification and suggests its potential as an imaging biomarker that complements guideline-based features of IPMN.
引用
- Maeba K, Kanki A, Fukukura Y, et al. Quantitative MRI of pancreatic parenchyma in intraductal papillary mucinous neoplasm: association with risk stratification based on guideline features. Eur Radiol. 2026. PMID: 42209832. doi:10.1007/s00330-026-12651-z
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。