title: Fibrosis, atrophy, and ductal pathology in chronic pancreatitis are associated with pancreatic function but independent of symptoms.
abstract: OBJECTIVE
  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.
authors.affiliation: From the *Mech-Sense, Department of Radiology, and †Mech-Sense, Department of Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg, Denmark; and ‡Center for Sensory-Motor Interactions (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Jens Brøndum
authors.initials: JB
authors.lastname: Frøkjær
authors.forename: Søren Schou
authors.initials: SS
authors.lastname: Olesen
authors.forename: Asbjørn Mohr
authors.initials: AM
authors.lastname: Drewes
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy; D016022:Case-Control Studies; D049448:Cholangiopancreatography, Magnetic Resonance; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005355:Fibrosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D010183:Pancreatic Ducts / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology*