CT perfusion and MR-elastography of the pancreas in predicting the risk of pancreatic fistula after pancreatoduodenectomy

Purpose . To compare the capabilities of CT perfusion and MR elastography in predicting the risk of developing pancreatic fistula in patients with periampular tumors at the planning stage of pancreatoduodenectomy. Materials and methods . CT perfusion and MR elastography were performed in 30 patients with no pancreatic diseases and 53 patients with periampular tumors, who were subsequently operated on in the volume of pancreatoduodenectomy. Results . In patients with periampular tumors in 18 (44%) cases, the perfusion and stiffness indices in the pancreatic parenchyma did not differ from the control group, 35 (85,3%) showed a decrease in the main perfusion parameters, while a moderate increase in stiffness was noted in 23 (65,7%), expressed in 12 (34,3%). Against the background of preventive measures, only 3 (5,6%) patients, in all cases with a «soft» pancreas in the postoperative period, developed a pancreatic fistula. Conclusion . CT perfusion and MR elastography are highly informative methods of quantitative and qualitative assessment of the pancreatic parenchyma, detection of fibrotic changes, and are effective in predicting the risk of developing pancreatic fistula.