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Master's Dissertation
DOI
10.11606/D.17.2017.tde-02022016-105600
Document
Author
Full name
Fábio Akira Uyeno
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2015
Supervisor
Committee
Elias Júnior, Jorge (President)
Barbosa, Marcello Henrique Nogueira
Lucchesi, Fabiano Rubião
Title in Portuguese
Avaliação do parênquima pancreático no Diabetes Mellitus através de métodos quantitativos de ressonância magnética
Keywords in Portuguese
Diabetes Mellitus
Pâncreas
Ressonância Magnética
Abstract in Portuguese
Objetivos: Comparar quantitativamente por técnicas de ressonância magnética (RM), a fração de gordura pancreática em indivíduos sadios, obesos e diabéticos (tipos 1 e 2). Secundariamente, buscou-se identificar diferença das medidas do ADC (difusão) no parênquima pancreático. Materiais e Métodos: Estudo retrospectivo com avaliação por dois radiologistas de imagens de RM abdominal de 89 indivíduos (56 controles; 33 diabéticos). Utilizadas três sequências: T1-GRE em fase e fora de fase; difusão (mapa ADC). Calculados e comparados frações de gordura e valores médios do ADC pancreáticos nos grupos. Resultados: Observaram-se diferenças significativas da fração de gordura pancreática entre diabéticos tipo 2 (DM2) e sadios e diabéticos tipo 1 (DM1), com valores de p de 0,01 e 0,02 para homens e 0,02 e 0,01 para mulheres, com confiabilidade interobservador ótima (coeficiente de correlação intraclasse > 0,8). Em obesos não diabéticos, observaram-se frações de gordura pancreática semelhantes às dos diabéticos tipo 2. Observou-se também diferença significativa nos valores de ADC entre DM2 e sadios e DM1 (p: 0,02 e 0,03 no sexo masculino; p: 0,002 e 0,001 no sexo feminino), menores nos DM2. Discussão: Observaram-se frações de gordura pancreáticas significativamente maiores em DM2, comparativamente a indivíduos sadios e DM1, achado que fomenta a hipótese da infiltração gordurosa do órgão como um fator causal associado para a falência de células beta pancreáticas.
Title in English
Evaluation of the pancreatic parenchyma in Diabetes Mellitus through quantitative Magnetic Resonance Imaging (MRI) techniques
Keywords in English
Diabetes Mellitus
Magnetic Resonance Imaging
Pancreas
Abstract in English
Objectives: To compare, through quantitative MRI techniques, the pancreatic fat fraction in healthy, obese and diabetic (type 1 and 2) individuals. Secondarily, weve tried to identify differences in ADC (diffusion) values in the pancreatic parenchyma. Materials and Methods: A retrospective study, with review, by two radiologists, of abdominal MR images of 89 subjects (56 controls; 33 diabetics). Three sequences have been used: T1-GRE in-phase and out-of-phase; diffusion (ADC map). Fat fractions and average values of the ADC in pancreatic parenchyma have been calculated and compared. Results: We observed significant differences between pancreatic fat fractions of diabetics type 2 (DM2) and healthy and diabetic type 1 (DM1) individuals, with p values of 0.01 and 0.02 for men and 0.02 and 0.01 for women, with good interobserver reliability (intraclass correlation coefficients > 0.8). Obese nondiabetic sujects showed high pancreatic fat fraction similar to DM2. There was also a significant difference in ADC values between DM2 and DM1 and healthy individuals (p: 0.02 and 0.03 in males; p: 0.002 and 0.001 in females), lower in DM2. Discussion: We observed significantly higher pancreatic fat fractions in DM2, when compared to healthy and DM1 individuals. This finding favors the hypothesis of fatty infiltration of the organ as an associated causal factor to the pancreatic beta cells failure.
 
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Publishing Date
2017-04-19
 
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