November 12, 2014
Notes: Fisher, Jessica M
Gardner, Timothy B
K23 DK088832/DK/NIDDK NIH HHS/
Gastrointest Endosc Clin N Am. 2013 Oct;23(4):787-802. doi: 10.1016/j.giec.2013.06.013. Epub 2013 Aug 1.
Author Address: Division of Gastroenterology, Department of Medicine, University of Washington, 1959 Northeast Pacific Street, Box 356424, Seattle, WA 98195, USA.
Reference Type: Journal Article
Record Number: 4941Author: Frokjaer, J. B., Olesen, S. S. and Drewes, A. M.
Title: Fibrosis, atrophy, and ductal pathology in chronic pancreatitis are associated with pancreatic function but independent of symptoms
Short Title: Fibrosis, atrophy, and ductal pathology in chronic pancreatitis are associated with pancreatic function but independent of symptoms
Alternate Journal: Pancreas
ISSN: 1536-4828 (Electronic)
Accession Number: 24048457
Cholangiopancreatography, Magnetic Resonance
Diffusion Magnetic Resonance Imaging
Abstract: OBJECTIVES: More knowledge into the pathophysiology underlying pain and other complications in chronic pancreatitis (CP) is needed. The aim was to associate advanced imaging information of the pancreas with etiology and clinical and laboratory parameters of CP. METHODS: Magnetic resonance cholangiopancreatography including diffusion-weighted imaging was obtained in 23 patients with painful CP and 17 controls. Apparent diffusion coefficients, ductal pathology, and pancreas atrophy were assessed. Etiology of CP and clinical and laboratory parameters including pain scores were correlated with the imaging findings. RESULTS: The patients had restricted apparent diffusion coefficients, that is, fibrotic changes, compared with the controls (P = 0.0003). The diffusion coefficients were not associated with atrophy- or ductal-related parameters (all P > 0.7). The fibrotic changes as well as atrophy- and ductal-related parameters were not associated with pain or any other symptom parameters (all P > 0.05). Alcoholic etiology was associated with ductal pathology (both P = 0.02). Furthermore, atrophy- and ductal-related parameters were associated with vitamin D, phosphate, hemoglobin, and glycated hemoglobin levels (all P < 0.03). CONCLUSIONS: Patients with CP have fibrosis, atrophy, and ductal pathology. Although changes in atrophy- and ductal-related parameters were, to some degree, associated with exocrine and endocrine insufficiency, pain and other symptoms seem to have a more complex pathogenesis independent of imaging pathology.