Furkan KAYA, Ahmet Oğuzhan TÜRKER, Ayberk BERAL, Nihan TEZCAN, Ahmet PENBE, Kadir BOZOK, İsmail AKYÜREK

PANKREAS YAĞLANMASININ VÜCUT ADİPOZ DOKU DAĞILIMI İLE İLİŞKİSİNİN BİLGİSAYARLI TOMOGRAFİDE KANTİTATİF YÖNTEMLERLE DEĞERLENDİRİLMESİ

AMAÇ: Pankreas yağlanması, yağ hücrelerinin pankreas dokusuna infiltrasyonu ile oluşan histopatolojik bir durumdur. Bu çalışmada pankreas yağlanmasının bilgisayarlı tomografide kantitatif yöntemlerle subkutan ve visseral yağlı doku miktarı, bel çevresi, yaş, cinsiyet ve karaciğer yağlanması ile arasındaki ilişkiyi değerlendirmeyi amaçladık.GEREÇ VE YÖNTEM: Üriner sistem taşı veya travma nedeniyle kontrastsız bilgisayarlı tomografi (BT) çektirmiş hastalar retrospektif olarak tarandı. Bilinen pankreas hastalığı olanlar ile diabetes mellitus öyküsü olanlar çalışmaya dahil edilmedi. Çalışmaya toplam 287 yetişkin olgu dahil edildi. İş istasyonundan pankreas, karaciğer ve dalağın Hounsfield Ünite (HU) cinsinden ortalama dansiteleri hesaplandı. Tüm hastaların visseral ve subkutan yağ dokusu miktarı lumber 3 ve 4 vertebra (L3/4) orta düzeyinden tek kesitte bir yazılım programı olan Aquarius, ToshibaMedical systems ile cm2 cinsinden, aynı seviyeden bel çevresi uzunluğu mm olarak ölçüm yapılarak değerlendirildi. Yağlı pankreası olan ve olmayan olgularda bulgular uygun istatistik yöntemlerle korelasyonları değerlendirildi.BULGULAR: Çalışamaya dahil edilen olguların %70’inde pankreas yağlanması tespit edildi. Pankreas yağlanması olan ve olmayan olgular karşılaştırıldığında subkutan yağlı doku miktarı ve cinsiyetle arasında anlamlı farklılık saptanmadı (sırasıyla p=0,681 ve p= 0,070). Pankreas yağlanması olanlarda total ve visseral yağlı doku miktarı belirgin fazla olarak izlendi. Karaciğer yağlanması toplam 40 olguda izlenmiş olup pankreas yağlanması olan olguların %16.4’ünde KC yağlanması vardı. Pankreas ve karaciğer yağlanması arasında anlamlı ilişki saptanmadı (p=0,064).SONUÇ: Pankreas yağlanması olanlarda ortalama dansite en güçlü negatif korelasyonu visseral yağlı doku miktarı ile göstermiştir. Ortalama visseral yağlı doku miktarı pankreas yağlanması olanlarda anlamlı derece yüksek izlenmiştir. Çalışmamızın sonuçları pankreas yağlanmasının en çok visseral yağlı doku artışı ile ilişkili olabileceğini göstermektedir. Bu nedenle bilgisayarlı tomografide basit kantitatif yöntemlerle bel çevresi ve visseral yağ doku miktarı artmış ileri yaş olgularda pankreas yağlanması açısından değerlendirilmesi gerektiğini düşünmekteyiz.

Anahtar Kelimeler:

bilgisayarlı tomografi, pankreas, visseral, subkutan, yağlı doku

EVALUATION OF THE RELATIONSHIP BETWEEN PANCREATIC STEATOSIS AND BODY ADIPOSIS TISSUE DISTRIBUTION IN COMPUTERIZED TOMOGRAPHY BY QUANTITATIVE METHODS

OBJECTIVE: Pancreatic steatosis is a condition caused by histopathological infiltration of fat cells in the pancreatic tissue. In this study, we evaluated the relationship between pancreatic steatosis and the amount of subcutaneous adipose tissue, visceral tissue quantity, waist circumference, age, sex, and fatty liver values with quantitative computed tomography.MATERIAL AND METHODS: In this study, images of the patient who underwent unenhanced computed tomography (CT) for urinary stones or trauma were retrospectively analyzed. Patients with known pancreatic disease and a history of diabetes mellitus were not included. A total of 287 adult cases were included in the study. The average densities of the pancreas, liver, and spleen in Hounsfield Units (HU) were calculated from the workstation. Visceral and subcutaneous adipose tissue in cm2 and waist circumference in mm were measured in all patients using Aquarius, Toshiba Medical system software from a single section passing through the mid-level of the lumbar 3 and 4 (L3/4) vertebrae. Correlations of the findings were evaluated using appropriate statistical methods in patients with and without a fatty pancreas.RESULTS: In 70% of the cases included in the study, pancreatic steatosis was detected. When the patients with and without pancreas steatosis were compared, there was no significant difference between the amount of subcutaneous fatty tissue and gender (p = 0.681 and p = 0.070, respectively). The amount of total and visceral fatty tissue was significantly higher in those with pancreatic steatosis. Fatty liver was detected in a total of 40 cases. 16.4% of patients with pancreatic steatosis had liver steatosis. There was no significant relationship between pancreatic and liver steatosis (p=0.064).CONCLUSIONS: Pancreatic density showed a strong negative correlation with the amount of visceral adipose tissue in patients with pancreatic steatosis. The visceral average amount of fatty tissue was observed significantly higher in patients with pancreatic steatosis. The results of our study indicate that the visceral adipose tissue increase may be associated with increased pancreatic steatosis. Therefore, we believe that the quantitative computed tomography method should be used elderly patients with increased waist circumference and visceral adipose tissue with simple quantitative methods in terms of pancreatic steatosis.

Keywords:

Computed Tomography, Pancreas, Visceral,

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