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Normal Pancreas Graft Appearance in Magnetic Resonance Diffusion Tensor Imaging (DTI)

Agnieszka Surowiecka, Michał Frączek, Bartosz Mruk, Marta Matejak-Górska, Jerzy Walecki, Marek Durlik, Katarzyna Sklinda

Department of Gastroenterological Surgery and Transplantation, Central Clinical Hospital of the Ministry of the Interior and Administration (CSK MSWiA), Centre of Postgraduate Medical Education, Warsaw, Poland

Med Sci Monit 2020; 26:e920262

DOI: 10.12659/MSM.920262

Available online: 2020-06-22

Published: 2020-08-23

BACKGROUND: The main purpose of diagnostic imaging after pancreas transplantation is to exclude potential complications. As long as standard anatomical imaging such as sonography, contrast-enhanced computed tomography, and magnetic resonance imaging (MRI) are sufficient to display macroscopic vasculature, early changes within the graft caused by insufficient microperfusion will not be displayed for evaluation.
MATERIAL AND METHODS: Patients with pancreas allograft function in good condition were included in the study. No specific preparation was demanded before the MRI examination. The results of MRI were correlated with Igls criteria. It was a preliminary study to examine diffusion tensor imaging (DTI) value and safety in pancreas transplantation.
RESULTS: Our results indicated that higher fractional anisotropy (FA) values of the graft’s head were associated with delayed graft function and insulin intake. We also compared grafts’ images in early and late periods and found differences in T1 signal intensity values. DTI is a reliable noninvasive tool, requiring no contrast agent, to assess graft microstructure in correlation with its function, with FA values showing the most consistent results. By Igls criteria, no graft failure, 76% had optimal function, 10% had good function, and 14% had marginal function.
CONCLUSIONS: Our results suggest that DTI can be safely used in patients after pancreas transplantation and is advantageous in detecting early as well as late postoperative complications such as intra-abdominal fluid collection, malperfusion, and ischemia of the graft. Our findings correspond with clinical condition and Igls criteria. DTI is free of ionizing agents and is safe for kidney grafts.

Keywords: Diffusion Magnetic Resonance Imaging, diffusion tensor imaging, Magnetic Resonance Imaging, Pancreas Transplantation