胰腺大体形态的增龄变化:191例胰腺磁共振图像分析

Age-related morphological changes of the pancreas: an analysis of 191 cases with magneticresonance pancreatography

目的采用磁共振成像(MRI)技术观察人体胰腺大体形态的增龄变化。方法﹐从2017年1月至2019年10月在华东医院健康体检对象中选取研究对象,按年龄分为20~29岁、30-39岁、40-49岁、50~59岁,60~69岁、70~79岁和≥80岁(每组20~30例)7组,在此基础上再分为中青年组(<60岁)和老年组(≥60岁)两组,采用MRI技术观察各组胰腺的大体形态特点,分析各年龄组胰腺头、体、尾部前后径和胰腺体积的差异及其与年龄的关系。结果符合入选条件的研究对象共191例,其中男性96例(50.3%)、女性95例(49.7%),20~29岁组28例、30~39岁组28例、40~49岁组27例、50~59岁组26例,60~69岁组30例、70~79岁组28例和≥80岁组24例;中青年组109例、老年组82例。老年人胰腺磁共振图像的直观表现为:胰腺出现萎缩、以胰腺尾部为著,胰腺边缘不平整呈锯齿状,可见分裂样胰腺小叶分布,T3、T2加权序列可见胰腺信号不均匀,反相T1加权序列可见胰腺脂肪变性的“勾边效应”,主胰管呈增粗趋势。胰腺头、体、尾前后径及体积在30~39岁达峰值,分别为(28.21±4.55)mm,(24.00±4.45)mm,(24.91±5.08)mm、(100.91±27.44)cm^(3),此后逐渐下降,≥80岁组分别为(18.87±3.82)mm、(15.63±3.96)mm,(13.70±3.70)mm,(43.88±10.47)cm^(3),降幅分别为33.10%、34.88%、45.00%、56.51%。老年组胰腺头体、尾前后径及体积分别为(21.59±4.35)mm,(18.10±4.29)mm,(17.00±4.56)mm,(59.85±22.73)cm^(3),低于中青年组(26.18±4.57)mm,(22.10±4.64)mm、(22.42±4.71)mm,(90.09±25.06)cm^(3),差异具有统计学意义(t=7.12、6.19、8.10、8.71,均P<0.001)。胰腺头、体、尾部前后径及体积均与年龄呈负相关(r=-0.52、-0.45、-0.56、-0.57,均P<0.001)。结论胰腺头﹑体、尾前后径及体积于30~39岁达峰值,此后随增龄逐渐萎缩,60岁后萎缩加剧,形态退化,主胰管呈逐渐增粗趋势。

Objective To investigate age-related morphological changes of the pancreas inhealthy people using magnetic resonance imaging(MRI). Methods From January 2017 to October2019 , people who took physical examinations at our hospital were enrolled and were divided into 7 groups according to age:20-29 years old,30-39 years old,40-49 years old,50-59 years old,60-69 yearsold,70-79 years old and ≥80 years. Also, the former four groups were classified as young and middle-aged(<60 years old)and the latter three as the elderly(≥60 years old). Morphological characteristicsof the pancreas in each group were examined via MRI. Differences in parameters such asanteroposterior diameters of the head,body and tail and the pancreatic volume between the groups andthe relationship between these parameters and age were analyzed. Results A total of 191 cases whomet the inclusion criteria were enrolled, including 96(50.3%)males and 95(49.7%)females, with 28aged 20-29 years,28 aged 30-39 years,27 aged 40-49 years,26 aged 50-59 years,30 aged 60-69 years,28aged 70-79 years and 26 aged ≥80 years. There were 109 cases in the young and middle-agedcategory and 82 cases in the elderly category.MRl findings included pancreatic atrophy, which wasmost obvious in the tail;uneven and serrated edges of the pancreas and pancreatic lobulation;unevensignal intensity in the T1-and Tg-weighted sequences;the" crispening effect" of pancreatic steatosis inthe opposed-phase T-weighted sequences,and a trend of widening of the main pancreatic duct. Theanteroposterior diameters of the pancreatic head, body and tail and the pancreatic volume reached thepeak at(28.21±4.55)mm,(24.00±4.45)mm,(24.91±5.08)mm and(100.91±27.44)cm^(3)between30-39 years of age,and then gradually decreased to(18.87±3.82)mm,(15.63±3.96)mm,(13.70±3.70)mm and(43.88±10.47)cm^(3)in those aged ≥80 years, with a decrease of 33.10%,34.88%,45.00% and 56.51%, respectively. The anteroposterior diameters of the pancreatic head, body,tail andthe pancreatic volume in the elderly were(21.59±4.35)mm,(18.10±4.29)mm,(17.00±4.56)mmand(59.85±22.73)cm^(3) ,which were smaller than those in the young and middle-aged category[(26.18±4.57)mm,(22.10±4.64)mm,(22.42±4.71)mm and(90.09±25.06)cm^(3)], and the differenceswere statistically significant(t = 7.12,6.19,8.10 and 8.71,respectively, all P<0.001). Theanteroposterior diameters of the head,body and tail and the panéreatic volume were negativelycorrelated with age(r=-0.52,-0.45,-0.56 and -0.57,respectively,P<0.001). ConclusionsThe anteroposterior diameters of the head, body and tail and the pancreatic volume reach the peakbetween 30-39 years of age,and then gradually start to decline with the increase of age. After age 60,the decline become more evident,showing morphological signs of degeneration and dilatation of themain pancreatic duct.