Quantitative T2 Mapping of Acute Pancreatitis

Fabio Porões; Naïk Vietti Violi; Giulia Piazza; Emilie Uldry; Enrique Lázaro-Fontanet; Sérgio Gaspar-Figueiredo; Tom Hilbert; Jean-Baptiste Ledoux; Alban Denys; Frédéric Schütz; Sabine Schmidt

doi:10.1002/jmri.29355

Quantitative T2 Mapping of Acute Pancreatitis

J Magn Reson Imaging. 2024 Mar 14. doi: 10.1002/jmri.29355. Online ahead of print.

Authors

Fabio Porões^{1

2}, Naïk Vietti Violi^{1

3}, Giulia Piazza⁴, Emilie Uldry⁴, Enrique Lázaro-Fontanet⁴, Sérgio Gaspar-Figueiredo⁴, Tom Hilbert^{3

5

6}, Jean-Baptiste Ledoux^{3

7}, Alban Denys³, Frédéric Schütz⁸, Sabine Schmidt^{1

3}

Affiliations

¹ University of Lausanne (UNIL), Lausanne, Switzerland.
² Department of Radiology, Cantonal Hospital Fribourg, Fribourg, Switzerland.
³ Department of Diagnostic and Interventional Radiology, University Hospital (CHUV), Lausanne, Switzerland.
⁴ Department of Visceral Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
⁵ Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland.
⁶ LTS5, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
⁷ Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.
⁸ Biostatistics Platform, Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland.

PMID: 38483105
DOI: 10.1002/jmri.29355

Abstract

Background: Quantification of the T2 signal by means of T2 mapping in acute pancreatitis (AP) has the potential to quantify the parenchymal edema. Quantitative T2 mapping may overcome the limitations of previously reported scoring systems for reliable assessment of AP.

Purpose: To evaluate MR-derived pancreatic T2 mapping values in AP and correlate them with markers of disease severity.

Study type: Prospective single-center study.

Population: 76 adults with AP (20-91 years, females/males: 39/37).

Field strength/sequence: Fat suppressed multiecho spin-echo prototype sequence to quantify T2 signal at 3T MRI.

Assessment: The severity of AP was assessed clinically, biologically, and by contrast-enhanced CT (CECT) performed 48-72 hours after symptom onset. MRI was then performed ≤24 hours after CT. Two readers blinded to any clinical information independently evaluated the T2 values by placing three regions of interest inside the pancreatic head, body, and tail on the T2 mapping MR sequence. Results were compared with corresponding CECT images as the standard and clinical severity parameters, using the length of hospital stay as our primary endpoint.

Statistical tests: Continuous variables were compared using the Spearman's rank correlation coefficient, analysis of variance (ANOVA) or Student's t-test.

Results: T2 values significantly correlated with the length of hospital stay (r_s (74) = 0.29), CT severity index (CTSI) (r_s (73) = 0.61; CTSI 0-3: 72 ± 14 msec, CTSI 4-10: 88 ± 15), intensive care unit (ICU) admission (t(2.77) = -3.41) and presence of organ failure (t(6.72) = -3.42), whereas the CTSI and Ranson score were not significantly related with ICU admission (CTSI: P = 0.24; Ranson score: P = 0.24) and organ failure (CTSI: P = 0.11; Ranson score P = 0.11).

Conclusion: T2 mapping correlates with AP severity parameters and is useful for assessing the severity of AP with higher sensitivity than the usual clinical and radiological scoring systems.

Level of evidence: 1 TECHNICAL EFFICACY: Stage 2.

Keywords: T2-mapping; acute pancreatitis; magnetic resonance imaging; pancreatic parenchymal edema.