@article{oai:nagasaki-u.repo.nii.ac.jp:00017505,
 author = {Tajima, Yoshitsugu and Kuroki, Tamotsu and Tsuneoka, Noritsugu and Adachi, Tomohiko and Isomoto, Ichiro and Uetani, Masataka and Kanematsu, Takashi},
 issue = {1},
 journal = {The Journal of surgical research},
 month = {Jan},
 note = {BACKGROUND: The time-signal intensity curve (TIC) of the pancreas obtained from dynamic contrast-enhanced magnetic resonance imaging closely reflects the histological degree of pancreatic fibrosis. MATERIALS AND METHODS: Seventy-six patients who had undergone a pancreatic TIC analysis prior to receiving a pancreaticoduodenectomy for various reasons were subjected to a yearly monitoring with pancreatic TIC for the pancreatic remnants. The pancreatic TIC profiles were classified into 3 types: type I, indicating a normal pancreas without fibrosis; and types II and III indicating fibrotic pancreas. RESULTS: The preoperative pancreatic TICs were type-I in 51 patients, type-II in 20, and type-III in 5, and the corresponding pancreatic fibrosis ratios were proved histologically to be 4.1%, 13.3%, and 21.2%, respectively. The mean postoperative follow-up period was 40.2 mo. A type-I changed to type-II in 16 patients, by 32.3 mo after surgery. In these patients, the exocrine remnant pancreatic function was preserved at the time of TIC conversion, but it significantly deteriorated thereafter. Pancreatic anastomotic leakage was found to be a significant risk factor predisposing a patient to undergo postoperative TIC conversion. In contrast, a preoperative type-II or III showed a postoperative conversion to type-I or II in 6 patients. In this group, the exocrine pancreatic function was noted to show a good recovery. In 35 patients who had a type-I TIC throughout the study, the remnant pancreatic function was well maintained. CONCLUSIONS: Pancreatic TIC analysis has the ability to detect an early fibrotic change that precedes a functional deterioration of the pancreatic remnant after a pancreaticoduodenectomy. Following a pancreaticoduodenectomy, some patients show an improvement in pancreatic fibrosis, but they may also experience remnant pancreatic fibrosis when pancreatic anastomotic leakage occurs after surgery., Journal of Surgical Research, 158(1), pp.61-68; 2010},
 pages = {61--68},
 title = {Monitoring Fibrosis of the Pancreatic Remnant After a Pancreaticoduodenectomy With Dynamic MRI.},
 volume = {158},
 year = {2010}
}