Normative Pancreatic Stiffness Levels and Related Influences Established by Magnetic Resonance Elastography in Volunteers

Background: Large-scale normative studies of pancreatic stiffness and potential influences have yet to be pursued via magnetic resonance elastography (MRE). Purpose: To determine normative MRE-based pancreatic stiffness values and to examine related influential factors. Study Type: Prospective. Subjects: In all, 361 volunteers (men, 199; women, 162) with a median age of 54.0 years and a median body mass index (BMI) of 22.86 kg/m² were prospectively recruited. Those with no histories of smoking, alcohol abuse, and diabetes mellitus (DM) were grouped as healthy volunteers, designating all others as positive controls. Field Strength/Sequence: Each volunteer underwent 3.0T pancreatic MRI at a frequency of 40 Hz. Assessment: Pancreatic stiffness values, pancreatic width and volume, waist circumference, and wave distance were measured in all subjects. Statistical Tests: Multiple linear regression analyses were performed to determine variables that influence MRE-determined stiffness. Results: The mean pancreatic stiffness in all volunteers was 1.20 ± 0.16 kPa. Stiffness levels in positive control volunteers proved significantly greater than levels in healthy volunteers (1.29 ± 0.17 kPa vs. 1.14 ± 0.13 kPa; P < 0.001). In multiple linear regression analysis, sex (P = 0.004), BMI (P < 0.001), pancreatic width (P = 0.005), smoking (P < 0.001), alcohol abuse (P < 0.001), and DM (P = 0.001) emerged as significant independent factors impacting pancreatic stiffness. Smoking, alcohol abuse, DM, and wide pancreas were associated with greater pancreatic stiffness (coefficients = 0.202, 0.183, 0.149, and 0.160, respectively), while reduced pancreatic stiffness corresponded with female sex and larger BMI (coefficient = −0.155 and −0.192, respectively). Data Conclusion: MRE-based pancreatic stiffness values are impacted by sex, BMI, pancreatic width, smoking, alcohol abuse, and DM. Reference values are essential for future clinical studies. Level of Evidence: 1. Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2020;52:448–458.