The Role of Magnetic Resonance Imaging for Evaluation of Pancreatic Lipomatosis After Bariatric Surgery

Abstract

Aim:To investigate the role of non-contrast magnetic resonance imaging (MRI) and findings of quantitative MRI in the evaluation of pancreatic lipomatosis in patients undergoing bariatric surgery.Methods:Pre-operative and post-operative MRI findings and laboratory test results of 44 obese patients, who underwent sleeve gastrectomy, were reviewed retrospectively. Liver craniocaudal length, hepatic and pancreatic region of interest (ROI) ratios at in-phase and out-of phase sequences (in-phase/out-of phase), pancreas/spleen ROI ratio on T2-weighted sequence (T2 ratio) and thickness of subcutaneous fat were estimated. The relationship between pre-operative and postoperative findings was analyzed.Results:A total of 44 (41 female, three male) patients with a mean age of 42 were included in the study. Liver length, hepatic and pancreatic in-phase/out-of phase ratios, pancreas/spleen T2 ratio and thickness of subcutaneous fat in the post-operative period were found to be lower than those in the pre-operative period (p<0.05). When pancreas/spleen T2 ratio ≥1 was considered abnormal for the diagnosis of pancreatic lipomatosis, high specificity (100%), positive predictive value (100%) and accuracy (75%) were obtained.Conclusion:Non-enhanced MRI with quantitative measurements, including pancreas/spleen T2 ratios, can be performed efficiently for the diagnosis of pancreatic lipomatosis and patient follow-up.

Keywords

• Bariatric surgery
• obesity
• magnetic resonance imaging
• pancreatic lipomatosis