Quantification of parenchymal calcifications in chronic pancreatitis: relation to atrophy, ductal changes, fibrosis and clinical parameters

Abstract

Objectives: Parenchymal calcifications are considered a hallmark finding of chronic pancreatitis (CP), but little is known about its relation to the clinical presentation and other morphological features such as atrophy, fibrosis and ductal changes. The aim was to quantify the number and maximal size of parenchymal calcifications assessed on computed tomography (CT) and to explore the association with other CT and magnetic resonance imaging (MRI)–based pancreatic features and clinical parameters.

Methods: A well-characterised cohort of 54 CP patients was included. CT measurements included number and size of parenchymal calcifications, gland diameter and ductal diameter. MRI measurements included gland volume, ductal diameter, fibrosis (diffusion) and fatty infiltration (Dixon). Clinical parameters included body mass index (BMI), CP duration and aetiology, M-ANNHEIM clinical stage, tobacco use, alcohol consumption, the presence of diabetes, faecal elastase, clinical pain score and quality of life.

Results: There were no correlations between the number and size of parenchymal calcifications and any of the other morphological CT and MRI parameters (all p > .05), except for larger size of calcifications in patients with high number of calcifications (p < .001). The number of parenchymal calcifications was negatively correlated with BMI (r = −0.35, p = .0088). The number and size of parenchymal calcifications did not correlate with any of the other clinical parameters (all p > .2).

Conclusion: Our findings could indicate the existence of parenchymal calcifications as an independent pathophysiological process involved in the development of CP.

Translational impact: Quantifications of calcifications could, in combination with other imaging biomarkers, be a useful imaging marker relevant for characterising CP.

Keywords:

• Chronic pancreatitis
• calcification
• morphology
• computed tomography
• magnetic resonance imaging

Acknowledgments

The study was supported by the Obelske Family Foundation.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

Supported by the Obelske Family Foundation where the present work was independent of the funding.Institutional review board statement: The study was approved by the North Denmark Region Committee on Health Research Ethics (N-20130040).Informed consent statement: Informed written consent was obtained from the patients after both oral and written information had been given.Data sharing statement: Participants gave informed consent for data sharing.