MRI and MRCP findings of the pancreas in patients with diabetes mellitus: compared analysis with pancreatic exocrine function determined by fecal elastase 1.
OBJECTIVE
To review magnetic resonance imaging and magnetic resonance cholangiopancreatography (MRCP) findings in patients with diabetes mellitus (DM), with pancreatic exocrine insufficiency, and with combined pancreatic exocrine insufficiency and DM.


METHODS
MRI/MRCP findings of 82 consecutive patients with DM (n=28), pancreatic exocrine insufficiency (n=25), and combination of both (n=29) were evaluated and compared with MRI/MRCP findings of 21 healthy volunteers with normal pancreatic exocrine function. Pancreatic exocrine function was determined by fecal elastase 1. MRCP images were evaluated according to the Cambridge classification. MRI of the pancreas was assessed for pancreatic size, signal intensity ratio (SIR), and arterial/venous enhancement ratio (A/V).


RESULTS
On MRI, significant difference was present in terms of mean values of pancreatic size (P<0.0001), A/V (P<0.02), and SIR (P<0.005) between the control group and groups of patients with DM, pancreatic exocrine insufficiency, and combined DM and pancreatic exocrine insufficiency. No significant difference was observed between groups of patients with DM and pancreatic exocrine function alone in terms of pancreatic size, A/V, and SIR. Chronic pancreatitis MRCP findings were present with increasing frequency in groups of DM, pancreatic exocrine insufficiency, and combination of both.


CONCLUSIONS
MRI/MRCP findings suggesting chronic pancreatitis may exist in patients with DM comparable to patients with pancreatic exocrine insufficiency. The frequency and severity of MRI/MRCP findings increase when the patients have combined DM and pancreatic exocrine insufficiency.
Bilgin
Mehmet
M
Department of Radiology, University Hospital Giessen and Marburg, Giessen, Germany.
Balci
Numan Cem
NC
Momtahen
Amir Javad
AJ
Bilgin
Yaşar
Y
Klör
Hans-Ulrich
HU
Rau
Wigbert S
WS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D048909:Diabetes Complications / Q000453:epidemiology / Q000473:pathology; D010188:Exocrine Pancreatic Insufficiency / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D005243:Feces / Q000201:enzymology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*; D010196:Pancreatic Elastase / Q000032:analysis*; D010186:Pancreatic Function Tests; D050500:Pancreatitis, Chronic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology
D010196:Pancreatic Elastase