November 12, 2014
World J Hepatol. 2013 Nov 27;5(11):649-53. doi: 10.4254/wjh.v5.i11.649.
Author Address: Elchanan Nussinson, Azmi Shahbari, Fahmi Shibli, Gastroenterology Institute, Emek Medical Center, Rabin st’ Afula 18101, Israel.
Reference Type: Journal Article
Record Number: 4736Author: Oki, H., Hayashida, Y., Oki, H., Kakeda, S., Aoki, T., Taguchi, M., Harada, M. and Korogi, Y.
Title: DWI findings of autoimmune pancreatitis: Comparison between symptomatic and asymptomatic patients
Journal: J Magn Reson Imaging
Date: Nov 22
Short Title: DWI findings of autoimmune pancreatitis: Comparison between symptomatic and asymptomatic patients
Alternate Journal: Journal of magnetic resonance imaging : JMRI
ISSN: 1522-2586 (Electronic)
Accession Number: 24273124
Abstract: PURPOSE: To compare the MR findings including diffusion-weighted imaging (DWI) between symptomatic and asymptomatic patients with autoimmune pancreatitis (AIP) and to determine whether DWI can be used as an objective biomarker for symptomatic AIP, which is considered an indication for steroid therapy. MATERIALS AND METHODS: This retrospective study was approved by our institutional review board. MRI scans from 37 patients with AIP (symptomatic, n = 19; asymptomatic, n = 18) were retrospectively evaluated. The imaging studies were performed on a 1.5 Tesla scanner and assessed for parenchymal enlargement, narrowing of the main pancreatic duct, hypointensity on fat-suppressed T1-weighted images (FS-T1WI), a capsule-like rim, extrapancreatic lesions, and hyperintensity on DWI. The findings were compared by univariate and multivariate logistic regression analysis. Apparent diffusion coefficient (ADC) values were also calculated. RESULTS: Multivariate analysis showed that hyperintensity on DWI were most significantly associated with the symptoms of AIP (odds ratio = 28.2; P = 0.003). Interobserver agreement for DWI was also high. The ADC values were significantly lower in symptomatic than in asymptomatic patients (0.94 +/- 0.17 versus 1.16 +/- 0.16 x 10-3 mm2 /s, P < 0.001). Receiver operating characteristic curve analysis of the ADC values to differentiate between symptomatic and asymptomatic patients showed that sensitivity was 68.4%, specificity 83.3%, and AUC 0.74. CONCLUSION: Signal intensity on DWI and ADC value were well correlated with the active symptoms of AIP patients. DWI may be useful as an objective biomarker for determining the indication for steroid therapy. J. Magn. Reson. Imaging 2013;. (c) 2013 Wiley Periodicals, Inc.