ObjectiveTo evaluate the value of 120 kV portal venous phase images combined with iodine maps created from dual-source dual-energy CT (DECT) for the diagnosis of pancreatic necrosis in the early stage of acute pancreatitis. MethodsThis prospective study enrolled 17 patients who underwent abdominal dual-source DECT within 72 hours from the onset of acute pancreatitis. All patients had received treatment in West China Hospital from May 2014 to August 2014. Comparison of the diagnostic value of 120 kV portal venous phase images alone and 120 kV portal venous phase images combined with iodine maps created from dual-source DECT was performed. ResultsSix of the 17 patients were found the presence of pancreatic necrosis (4 patients without obvious necrosis in the early stage developed to pancreatic necrosis, and 2 patients with the presence of necrosis in the early stage improved). The sensitivity, specificity, and accuracy of 120 kV portal venous phase images for the diagnosis of pancreatic necrosis were 50.0% (3/6), 100% (11/11), and 82.4% (14/17), respectively, and it had a good diagnostic value (AUC=0.856, P=0.018). The sensitivity, specificity, and accuracy of 120 kV portal venous phase images combined with iodine maps created from dual-source DECT for predicting pancreatic necrosis were 100% (6/6), 90.9% (10/11), and 94.1% (16/17), respectively, and this method had good value too (AUC=0.977, P=0.002), which higher than that of 120 kV portal venous phase images (P=0.002). ConclusionsThe 120 kV portal venous phase images combined with iodine maps created from dual-source DECT is helpful to improve subjective judgment in the diagnosis of pancreatic necrosis in the early stage of acute pancreatitis. It also contributes to the display of hypo-perfusion area of the pancreatic parenchyma, and has higher diagnostic value.
Objective To summarize the recent application progress of dual-energy CT in pancreatic imaging. Methods The domestic and international published literatures related to the application of dual-energy CT in pancreatic imaging in recent years were collected and reviewed. Results Dual-energy CT could provide the morphological image and function information of tissues and organs simultaneously. At present, the clinical application of dual-energy CT in pancreatic imaging included low tube voltage technology, iodine overlay, virtual non-enhanced imaging, and monoenergetic imaging. Conclusion Dual-energy CT could contribute to detecting pancreatic lesions, reducing radiation dose, and improving image quality in pancreatic imaging.
ObjectiveTo summarize the current application status and research progress of extracellular volume (ECV) fraction based on imaging examinations in pancreatic diseases. MethodThe literature relevant to research was summarized, including the clinical studies of the ECV fraction that based on computed tomography and magnetic resonance imaging in pancreatic inflammation, neoplastic lesions, fibrosis, and other diseases. ResultsBiopsy of pancreas was technically challenging due to its unique anatomical location. The ECV fraction was the quantitative index of extracellular matrix that played a regulatory role in the process of tumor proliferation and invasion. And the production of collagen fibers and the deposition of extracellular matrix could increase the extracellular space in the progression of tissue fibrosis. Therefore, the ECV fraction obtained based on imaging examination could not only avoid invasive examination, but also reflect the status of tumor microenvironment and evaluate the degree of tissue fibrosis. The ECV fraction had the potential to serve as a novel quantitative imaging evaluation index for pancreatic diseases. ConclusionsAccording to the current research status and progress of ECV fraction in pancreatic-related diseases, ECV fraction is increasingly being utilized as a non-invasive biomarker across various pancreatic-related conditions. It holds the potential to predict tumor grading, degree of fibrosis, post-chemotherapy response, cancer patient survival, etc. Consequently, it exhibits promising prospects for clinical application research.