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Erschienen in:
16.06.2020 | Original Article
Validation of threshold values for pancreas thickness and T1-weighted signal intensity ratio in the pediatric pancreas
Erschienen in: Pediatric Radiology | Ausgabe 10/2020
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Background
Pancreas atrophy and the loss of T1-weighted signal intensity by magnetic resonance imaging (MRI) are findings of chronic pancreatitis.
Objective
The purpose of this study was to test published normal values and cutoffs for pancreas thickness and the pancreas:spleen T1-weighted signal intensity ratio in children without pancreatic disease.
Materials and methods
This was a secondary analysis of prospectively collected MRI data for 50 children (range: 6.3–15.9 years; 27 female) with no history of pancreatic disease. Two observers (R1, R2) measured linear pancreas thickness on axial T1-weighted, fat-saturated gradient recalled echo images and placed regions of interest in the pancreas and spleen to calculate the T1-weighted signal intensity ratio. Measurements were compared to published pediatric normal values (computed tomography [CT], ultrasound [US]) and adult cutoffs (CT, MRI).
Results
Compared to published pediatric values for CT, 68% (R1: 34/50) or 40% (R2: 22/50) of participants had ≥1 pancreas segment with thickness below the normal range. No participant had a thickness value below the normal range published for US. Compared to cutoff values in adults, 84% (R1: 42/50) or 80% (R2: 40/50) of participants met the criteria for pancreas atrophy. Mean T1-weighted signal intensity ratio was 1.33±0.15 (R1) and 1.32±0.16 (R2). Twelve (R1: 24.5% of 49) or 11/49 (R2: 22.4%) participants had a T1-weighted signal intensity ratio below the threshold associated with exocrine insufficiency in adults.
Conclusion
Previously defined thresholds for pancreas thickness and pancreas:spleen T1-weighted signal intensity ratio appear too restrictive for a pediatric population. Further study is needed to define optimal quantitative metrics for findings of chronic pancreatitis in children.