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T1 signal intensity ratio correlation with T1 mapping in pediatric pancreatitis
Pradipta Debnath1, Jean Tkach1,2, Michelle Saad1,2
1Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
Insights
Pancreas T1 signal intensity ratio (SIR) in children correlates with T1 relaxation time at 1.5T MRI. This SIR is significantly lower in children with pancreatitis, aiding diagnosis.
Area of Science:
- Medical Imaging
- Pediatric Radiology
- Pancreatic Diseases
Background:
- Accurate assessment of pancreatic T1 relaxation time is crucial for diagnosing pediatric pancreatitis.
- T1-weighted signal intensity ratio (SIR) offers a potential non-invasive imaging biomarker.
Purpose of the Study:
- To investigate the correlation between pancreas T1-weighted signal intensity ratio (SIR) and T1 relaxation time in pediatric patients.
- To determine if T1 SIR differs between children with and without pancreatitis.
Main Methods:
- Retrospective analysis of T1-weighted gradient recalled echo images from 220 pediatric patients (<18 years).
- Calculation of pancreas-to-spleen (SIR-PS) and pancreas-to-paraspinal muscle (SIR-PM) ratios at 1.5T and 3T MRI.
- Correlation analysis (Spearman's) between T1 SIR and T1 relaxation time; comparison of SIR between healthy children and those with pancreatitis.
Main Results:
- At 1.5T, both SIR-PS and SIR-PM showed moderate negative correlations with T1 relaxation time (p < 0.0001).
- Significantly lower SIR-PS and SIR-PM values were observed in children with pancreatitis compared to healthy controls at 1.5T.
- Specific cut-off values for SIR-PS (≤1.31) and SIR-PM (≤1.53) demonstrated diagnostic potential for pancreatitis at 1.5T.
Conclusions:
- Pancreas T1 SIR, particularly SIR-PS, is a reliable imaging biomarker in children at 1.5T MRI, correlating with T1 relaxation time.
- Lower T1 SIR values are indicative of pancreatitis in pediatric patients, suggesting its utility in diagnosing pancreatic conditions.
Purpose:
Our primary purpose was to understand the correlation between pancreas T1-weighted signal intensity ratio (SIR) and T1 relaxation time in children. We also sought to characterize differences in T1 SIR between children without and with pancreatitis.
Methods:
Retrospective study of patients < 18-years-old. SIR-pancreas:spleen (SIR-PS) and SIR-pancreas:paraspinal muscle (SIR-PM) were generated from T1-weighted gradient recalled echo images. Subdivided by field strength, T1 SIR was correlated (Spearman's) with T1 relaxation time.
Results:
220 participants were included, 144 imaged at 1.5T (mean: 11.4 ± 4.2 years) and 76 imaged at 3T (mean: 10.9 ± 4.5 years). At 1.5T, SIR-PS (rho=-0.62, 95% CI: -0.71 to -0.51, p < 0.0001) and SIR-PM (rho=-0.57, 95% CI: -0.67 to -0.45, p < 0.0001) moderately negatively correlated with T1 relaxation time. At 3T, correlations between T1 SIR and T1 relaxation time were moderate (rho=-0.40 to -0.43, p ≤ 0.0003). SIR-PS was significantly different between patient groups at 1.5T (p < 0.0001) with pairwise differences between: normal vs. acute on chronic pancreatitis (1.52 vs. 1.13; p < 0.0001). SIR-PM was also significantly different between groups at 1.5T (p < 0.0001) with differences between: normal vs. acute pancreatitis (1.65 vs. 1.40; p = 0.0006), normal vs. acute on chronic pancreatitis (1.65 vs. 1.18; p < 0.0001), and normal vs. chronic pancreatitis (1.65 vs. 1.52; p = 0.0066). A SIR-PS cut-off of ≤ 1.31 had 44% sensitivity and 95% specificity and SIR-PM cut-off of ≤ 1.53 had 69% sensitivity and 70% specificity for pancreatitis. At 3T, SIR-PS was significantly different between groups (p = 0.033) but without significant pairwise differences.
Conclusion:
At 1.5T pancreas T1 SIR moderately to strongly correlates with estimated T1 relaxation time and is significantly lower in children with pancreatitis.
