Advances in study of extracellular volume fraction in pancreatic diseases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Xuejian ^1,2,3,4 , LIU Jialin ^1,2,3,4 , HU Ting ^1,2,3,4 , WU Yefan ^1,2,3,4 ,  ZHANG Hao ^2,3,4

1. The First Clinical Medical College of Lanzhou University, Lanzhou 730000, P. R. China;
2. Department of Radiology, The First Hospital of Lanzhou University, Lanzhou 730000, P. R. China;
3. Intelligent Imaging Medical Engineering Research Center of Gansu Province, Lanzhou 730000, P. R. China;
4. Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou 730000, P. R. China;

Corresponding author：

ZHANG Hao, Email: zhanghao@lzu.edu.cn

Keywords：

extracellular volume fraction; pancreatic diseases; dual-energy CT; magnetic resonance imaging

DOI：

10.7507/1007-9424.202310029

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the current application status and research progress of extracellular volume (ECV) fraction based on imaging examinations in pancreatic diseases. Method The literature relevant to research was summarized, including the clinical studies of the ECV fraction that based on computed tomography and magnetic resonance imaging in pancreatic inflammation, neoplastic lesions, fibrosis, and other diseases. Results Biopsy of pancreas was technically challenging due to its unique anatomical location. The ECV fraction was the quantitative index of extracellular matrix that played a regulatory role in the process of tumor proliferation and invasion. And the production of collagen fibers and the deposition of extracellular matrix could increase the extracellular space in the progression of tissue fibrosis. Therefore, the ECV fraction obtained based on imaging examination could not only avoid invasive examination, but also reflect the status of tumor microenvironment and evaluate the degree of tissue fibrosis. The ECV fraction had the potential to serve as a novel quantitative imaging evaluation index for pancreatic diseases. Conclusions According to the current research status and progress of ECV fraction in pancreatic-related diseases, ECV fraction is increasingly being utilized as a non-invasive biomarker across various pancreatic-related conditions. It holds the potential to predict tumor grading, degree of fibrosis, post-chemotherapy response, cancer patient survival, etc. Consequently, it exhibits promising prospects for clinical application research.

Citation： SUN Xuejian, LIU Jialin, HU Ting, WU Yefan, ZHANG Hao. Advances in study of extracellular volume fraction in pancreatic diseases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(3): 379-384. doi: 10.7507/1007-9424.202310029 Copy

1.	Ng SH, Lin CY, Chan SC, et al. Clinical utility of multimodality imaging with dynamic contrast-enhanced MRI, diffusion-weighted MRI, and ¹⁸F-FDG PET/CT for the prediction of neck control in oropharyngeal or hypopharyngeal squamous cell carcinoma treated with chemoradiation. PLoS One, 2014, 9(12): e115933.
2.	Sala E, Kataoka MY, Priest AN, et al. Advanced ovarian cancer: multiparametric MR imaging demonstrates response- and metastasis-specific effects. Radiology, 2012, 263(1): 149-159.
3.	Bali MA, Metens T, Denolin V, et al. Tumoral and nontumoral pancreas: correlation between quantitative dynamic contrast-enhanced MR imaging and histopathologic parameters. Radiology, 2011, 261(2): 456-466.
4.	Bandula S, Punwani S, Rosenberg WM, et al. Equilibrium contrast-enhanced CT imaging to evaluate hepatic fibrosis: initial validation by comparison with histopathologic sampling. Radiology, 2015, 275(1): 136-143.
5.	Luetkens JA, Homsi R, Sprinkart AM, et al. Incremental value of quantitative CMR including parametric mapping for the diagnosis of acute myocarditis. Eur Heart J Cardiovasc Imaging, 2016, 17(2): 154-161.
6.	杨璐, 翟亚楠, 卢世瑞, 等. 细胞外基质体积分数对肝纤维化的诊断价值. 兰州大学学报(医学版), 2017, 43(5): 7-12.
7.	Johnson TR, Krauss B, Sedlmair M, et al. Material differentiation by dual energy CT: initial experience. Eur Radiol, 2007, 17(6): 1510-1517.
8.	Martin SS, Trapp F, Wichmann JL, et al. Dual-energy CT in early acute pancreatitis: improved detection using iodine quantification. Eur Radiol, 2019, 29(5): 2226-2232.
9.	Li C, Lin X, Hui C, et al. Computer-aided diagnosis for distinguishing pancreatic mucinous cystic neoplasms from serous oligocystic adenomas in spectral CT images. Technol Cancer Res Treat, 2016, 15(1): 44-54.
10.	McNamara MM, Little MD, Alexander LF, et al. Multireader evaluation of lesion conspicuity in small pancreatic adenocarcinomas: complimentary value of iodine material density and low keV simulated monoenergetic images using multiphasic rapid kVp-switching dual energy CT. Abdom Imaging, 2015, 40(5): 1230-1240.
11.	McCollough CH, Leng S, Yu L, et al. Dual- and multi-energy CT: principles, technical approaches, and clinical applications. Radiology, 2015, 276(3): 637-653.
12.	中华放射学杂志双层探测器光谱CT临床应用协作组. 双层探测器光谱CT临床应用中国专家共识(第一版). 中华放射学杂志, 2020, 54(7): 635-643.
13.	Bak S, Kim JE, Bae K, et al. Quantification of liver extracellular volume using dual-energy CT: utility for prediction of liver-related events in cirrhosis. Eur Radiol, 2020, 30(10): 5317-5326.
14.	郑文霞, 王莉莉, 陈杏彪, 等. 光谱CT量化的细胞外容积评估结直肠癌神经、血管及淋巴管浸润. 中国医学影像学杂志, 2022, 30(9): 896-902.
15.	Flett AS, Hayward MP, Ashworth MT, et al. Equilibrium contrast cardiovascular magnetic resonance for the measurement of diffuse myocardial fibrosis: preliminary validation in humans. Circulation, 2010, 122(2): 138-144.
16.	Wang W, Fan X, Yang J, et al. Preliminary MRI study of extracellular volume fraction for identification of lymphovascular space invasion of cervical cancer. J Magn Reson Imaging, 2023, 57(2): 587-597.
17.	De Long NE, Holloway AC. Toxicity to the insulin-secreting β-cell // McQueen CA. Comprehensive Toxicology. Third Edition. Elsevier, 2018: 205-229.
18.	Noda Y, Goshima S, Tsuji Y, et al. Pancreatic extracellular volume fraction using T1 mapping in patients with impaired glucose intolerance. Abdom Radiol (NY), 2020, 45(2): 449-456.
19.	蔡晓艺, 季旸, 王国华, 等. 双能量CT测量胰腺细胞外体积分数及标准化碘浓度评估2型糖尿病. 中国医学影像技术, 2023, 39(3): 385-388.
20.	Zhu L, Wang S, Sun Z, et al. Extracellular volume fraction of the pancreas predicts glucose intolerance in patients undergoing major pancreatic surgeries. Eur J Radiol, 2023, 164: 110859.
21.	中华医学会外科学分会胰腺外科学组. 中国急性胰腺炎诊治指南(2021). 中华消化外科杂志, 2021, 20(7): 730-739.
22.	Conwell DL, Lee LS, Yadav D, et al. American pancreatic association practice guidelines in chronic pancreatitis: evidence-based report on diagnostic guidelines. Pancreas, 2014, 43(8): 1143-1162.
23.	黄会珍, 韩磊, 林晓冬, 等. 胰腺炎发病机制相关信号通路研究进展. 中国临床药理学与治疗学, 2023, 28(1): 109-113.
24.	路鸣, 王晨, 余静, 等. T1mapping和细胞外容积分数在诊断急性胰腺炎及复发性急性胰腺炎的应用价值初探. 磁共振成像, 2021, 12(11): 26-30.
25.	Stevens T, Conwell DL, Zuccaro G. Pathogenesis of chronic pancreatitis: an evidence-based review of past theories and recent developments. Am J Gastroenterol, 2004, 99(11): 2256-2270.
26.	Morita K, Nishie A, Ushijima Y, et al. Noninvasive assessment of liver fibrosis by dual-layer spectral detector CT. Eur J Radiol, 2021, 136: 109575.
27.	Shi S, Luo Y, Wang M, et al. Tumor fibrosis correlates with the survival of patients with pancreatic adenocarcinoma and is predictable using clinicoradiological features. Eur Radiol, 2022, 32(9): 6314-6326.
28.	Sun S, Huang B, Li Q, et al. Prediction of pancreatic fibrosis by dual-energy CT-derived extracellular volume fraction: comparison with MRI. Eur J Radiol, 2023, 170: 111204.
29.	Tirkes T, Lin C, Cui E, et al. Quantitative MR evaluation of chronic pancreatitis: extracellular volume fraction and MR relaxometry. AJR Am J Roentgenol, 2018, 210(3): 533-542.
30.	Fukui H, Onishi H, Nakamoto A, et al. Pancreatic fibrosis by extracellular volume fraction using contrast-enhanced computed tomography and relationship with pancreatic cancer. Eur J Radiol, 2022, 156: 110522.
31.	Fukukura Y, Kumagae Y, Higashi R, et al. Estimation of extracellular volume fraction with routine multiphasic pancreatic computed tomography to predict the survival of patients with stage Ⅳ pancreatic ductal adenocarcinoma. Pancreas, 2019, 48(10): 1360-1366.
32.	Fujita N, Ushijima Y, Itoyama M, et al. Extracellular volume fraction determined by dual-layer spectral detector CT: possible role in predicting the efficacy of preoperative neoadjuvant chemotherapy in pancreatic ductal adenocarcinoma. Eur J Radiol, 2023, 162: 110756.
33.	Fukukura Y, Kumagae Y, Higashi R, et al. Extracellular volume fraction determined by equilibrium contrast-enhanced dual-energy CT as a prognostic factor in patients with stage Ⅳ pancreatic ductal adenocarcinoma. Eur Radiol, 2020, 30(3): 1679-1689.
34.	Noid G, Godfrey G, Hall W, et al. Predicting treatment response from extracellular volume fraction for chemoradiation therapy of pancreatic cancer. Int J Radiat Oncol Biol Phys, 2023, 115(3): 803-808.
35.	武凌宇, 白潇涵, 余静, 等. 双能CT细胞外容积分数在鉴别胰腺导管内乳头状黏液性肿瘤良恶性中的应用价值. 南京医科大学学报(自然科学版), 2023, 43(9): 1273-1278.
36.	Kakizaki Y, Makino N, Tozawa T, et al. Stromal fibrosis and expression of matricellular proteins correlate with histological grade of intraductal papillary mucinous neoplasm of the pancreas. Pancreas, 2016, 45(8): 1145-1152.
37.	马娜, 李义兴, 徐一文, 等. 多层螺旋CT与MRI对胰腺神经内分泌肿瘤病理分级和肿瘤血供评估的前瞻性研究. 分子影像学杂志, 2023, 46(1): 129-134.
38.	Iwaya H, Fukukura Y, Hashimoto S, et al. Prognostic significance of extracellular volume fraction with equilibrium contrast-enhanced computed tomography for pancreatic neuroendocrine neoplasms. Pancreatology, 2021, 21(4): 779-786.
39.	Shubert CR, Wagie AE, Farnell MB, et al. Clinical risk score to predict pancreatic fistula after pancreatoduodenectomy: independent external validation for open and laparoscopic approaches. J Am Coll Surg, 2015, 221(3): 689-698.
40.	Shi HY, Lu ZP, Li MN, et al. Dual-energy CT iodine concentration to evaluate postoperative pancreatic fistula after pancreatoduodenectomy. Radiology, 2022, 304(1): 65-72.
41.	Zhu L, Sun Z, Dai M, et al. Tomoelastography and pancreatic extracellular volume fraction derived from MRI for predicting clinically relevant postoperative pancreatic fistula. J Magn Reson Imaging, 2023 May 20.
42.	Sofue K, Ueshima E, Masuda A, et al. Estimation of pancreatic fibrosis and prediction of postoperative pancreatic fistula using extracellular volume fraction in multiphasic contrast-enhanced CT. Eur Radiol, 2022, 32(3): 1770-1780.
43.	Steinkohl E, Olesen SS, Hansen TM, et al. T1 relaxation times and MR elastography-derived stiffness: new potential imaging biomarkers for the assessment of chronic pancreatitis. Abdom Radiol (NY), 2021, 46(12): 5598-5608.
44.	Akisik MF, Sandrasegaran K, Jennings SG, et al. Diagnosis of chronic pancreatitis by using apparent diffusion coefficient measurements at 3.0-T MR following secretin stimulation. Radiology, 2009, 252(2): 418-425.
45.	Liu Q, Zhang J, Jiang M, et al. Evaluating the histopathology of pancreatic ductal adenocarcinoma by intravoxel incoherent motion-diffusion weighted imaging comparing with diffusion-weighted imaging. Front Oncol, 2021, 11: 670085.
46.	Hecht EM, Liu MZ, Prince MR, et al. Can diffusion-weighted imaging serve as a biomarker of fibrosis in pancreatic adenocarcinoma?. J Magn Reson Imaging, 2017, 46(2): 393-402.
47.	Shi SY, Wang L, Peng Z, et al. Multi-frequency magnetic resonance elastography of the pancreas: measurement reproducibility and variance among healthy volunteers. Gastroenterol Rep (Oxf), 2022, 10: goac033.
48.	宋奇科, 钟时玲, 刘媛媛, 等. 磁共振弹性成像评价胰腺导管腺癌病理分级及生存期. 磁共振成像, 2022, 13(3): 26-30.
49.	熊晟原, 周星. 基于双层探测器光谱CT量化细胞外容积评估心肌组织学特性的研究进展. 中国医学影像学杂志, 2023, 31(3): 300-304.
50.	李庆阳, 张宇琦, 包佳琪, 等. 基于CT细胞外体积分数用于腹部疾病进展. 中国介入影像与治疗学, 2022, 19(12): 791-794.

1. Ng SH, Lin CY, Chan SC, et al. Clinical utility of multimodality imaging with dynamic contrast-enhanced MRI, diffusion-weighted MRI, and ¹⁸F-FDG PET/CT for the prediction of neck control in oropharyngeal or hypopharyngeal squamous cell carcinoma treated with chemoradiation. PLoS One, 2014, 9(12): e115933.
2. Sala E, Kataoka MY, Priest AN, et al. Advanced ovarian cancer: multiparametric MR imaging demonstrates response- and metastasis-specific effects. Radiology, 2012, 263(1): 149-159.
3. Bali MA, Metens T, Denolin V, et al. Tumoral and nontumoral pancreas: correlation between quantitative dynamic contrast-enhanced MR imaging and histopathologic parameters. Radiology, 2011, 261(2): 456-466.
4. Bandula S, Punwani S, Rosenberg WM, et al. Equilibrium contrast-enhanced CT imaging to evaluate hepatic fibrosis: initial validation by comparison with histopathologic sampling. Radiology, 2015, 275(1): 136-143.
5. Luetkens JA, Homsi R, Sprinkart AM, et al. Incremental value of quantitative CMR including parametric mapping for the diagnosis of acute myocarditis. Eur Heart J Cardiovasc Imaging, 2016, 17(2): 154-161.
6. 杨璐, 翟亚楠, 卢世瑞, 等. 细胞外基质体积分数对肝纤维化的诊断价值. 兰州大学学报(医学版), 2017, 43(5): 7-12.
7. Johnson TR, Krauss B, Sedlmair M, et al. Material differentiation by dual energy CT: initial experience. Eur Radiol, 2007, 17(6): 1510-1517.
8. Martin SS, Trapp F, Wichmann JL, et al. Dual-energy CT in early acute pancreatitis: improved detection using iodine quantification. Eur Radiol, 2019, 29(5): 2226-2232.
9. Li C, Lin X, Hui C, et al. Computer-aided diagnosis for distinguishing pancreatic mucinous cystic neoplasms from serous oligocystic adenomas in spectral CT images. Technol Cancer Res Treat, 2016, 15(1): 44-54.
10. McNamara MM, Little MD, Alexander LF, et al. Multireader evaluation of lesion conspicuity in small pancreatic adenocarcinomas: complimentary value of iodine material density and low keV simulated monoenergetic images using multiphasic rapid kVp-switching dual energy CT. Abdom Imaging, 2015, 40(5): 1230-1240.
11. McCollough CH, Leng S, Yu L, et al. Dual- and multi-energy CT: principles, technical approaches, and clinical applications. Radiology, 2015, 276(3): 637-653.
12. 中华放射学杂志双层探测器光谱CT临床应用协作组. 双层探测器光谱CT临床应用中国专家共识(第一版). 中华放射学杂志, 2020, 54(7): 635-643.
13. Bak S, Kim JE, Bae K, et al. Quantification of liver extracellular volume using dual-energy CT: utility for prediction of liver-related events in cirrhosis. Eur Radiol, 2020, 30(10): 5317-5326.
14. 郑文霞, 王莉莉, 陈杏彪, 等. 光谱CT量化的细胞外容积评估结直肠癌神经、血管及淋巴管浸润. 中国医学影像学杂志, 2022, 30(9): 896-902.
15. Flett AS, Hayward MP, Ashworth MT, et al. Equilibrium contrast cardiovascular magnetic resonance for the measurement of diffuse myocardial fibrosis: preliminary validation in humans. Circulation, 2010, 122(2): 138-144.
16. Wang W, Fan X, Yang J, et al. Preliminary MRI study of extracellular volume fraction for identification of lymphovascular space invasion of cervical cancer. J Magn Reson Imaging, 2023, 57(2): 587-597.
17. De Long NE, Holloway AC. Toxicity to the insulin-secreting β-cell // McQueen CA. Comprehensive Toxicology. Third Edition. Elsevier, 2018: 205-229.
18. Noda Y, Goshima S, Tsuji Y, et al. Pancreatic extracellular volume fraction using T1 mapping in patients with impaired glucose intolerance. Abdom Radiol (NY), 2020, 45(2): 449-456.
19. 蔡晓艺, 季旸, 王国华, 等. 双能量CT测量胰腺细胞外体积分数及标准化碘浓度评估2型糖尿病. 中国医学影像技术, 2023, 39(3): 385-388.
20. Zhu L, Wang S, Sun Z, et al. Extracellular volume fraction of the pancreas predicts glucose intolerance in patients undergoing major pancreatic surgeries. Eur J Radiol, 2023, 164: 110859.
21. 中华医学会外科学分会胰腺外科学组. 中国急性胰腺炎诊治指南(2021). 中华消化外科杂志, 2021, 20(7): 730-739.
22. Conwell DL, Lee LS, Yadav D, et al. American pancreatic association practice guidelines in chronic pancreatitis: evidence-based report on diagnostic guidelines. Pancreas, 2014, 43(8): 1143-1162.
23. 黄会珍, 韩磊, 林晓冬, 等. 胰腺炎发病机制相关信号通路研究进展. 中国临床药理学与治疗学, 2023, 28(1): 109-113.
24. 路鸣, 王晨, 余静, 等. T1mapping和细胞外容积分数在诊断急性胰腺炎及复发性急性胰腺炎的应用价值初探. 磁共振成像, 2021, 12(11): 26-30.
25. Stevens T, Conwell DL, Zuccaro G. Pathogenesis of chronic pancreatitis: an evidence-based review of past theories and recent developments. Am J Gastroenterol, 2004, 99(11): 2256-2270.
26. Morita K, Nishie A, Ushijima Y, et al. Noninvasive assessment of liver fibrosis by dual-layer spectral detector CT. Eur J Radiol, 2021, 136: 109575.
27. Shi S, Luo Y, Wang M, et al. Tumor fibrosis correlates with the survival of patients with pancreatic adenocarcinoma and is predictable using clinicoradiological features. Eur Radiol, 2022, 32(9): 6314-6326.
28. Sun S, Huang B, Li Q, et al. Prediction of pancreatic fibrosis by dual-energy CT-derived extracellular volume fraction: comparison with MRI. Eur J Radiol, 2023, 170: 111204.
29. Tirkes T, Lin C, Cui E, et al. Quantitative MR evaluation of chronic pancreatitis: extracellular volume fraction and MR relaxometry. AJR Am J Roentgenol, 2018, 210(3): 533-542.
30. Fukui H, Onishi H, Nakamoto A, et al. Pancreatic fibrosis by extracellular volume fraction using contrast-enhanced computed tomography and relationship with pancreatic cancer. Eur J Radiol, 2022, 156: 110522.
31. Fukukura Y, Kumagae Y, Higashi R, et al. Estimation of extracellular volume fraction with routine multiphasic pancreatic computed tomography to predict the survival of patients with stage Ⅳ pancreatic ductal adenocarcinoma. Pancreas, 2019, 48(10): 1360-1366.
32. Fujita N, Ushijima Y, Itoyama M, et al. Extracellular volume fraction determined by dual-layer spectral detector CT: possible role in predicting the efficacy of preoperative neoadjuvant chemotherapy in pancreatic ductal adenocarcinoma. Eur J Radiol, 2023, 162: 110756.
33. Fukukura Y, Kumagae Y, Higashi R, et al. Extracellular volume fraction determined by equilibrium contrast-enhanced dual-energy CT as a prognostic factor in patients with stage Ⅳ pancreatic ductal adenocarcinoma. Eur Radiol, 2020, 30(3): 1679-1689.
34. Noid G, Godfrey G, Hall W, et al. Predicting treatment response from extracellular volume fraction for chemoradiation therapy of pancreatic cancer. Int J Radiat Oncol Biol Phys, 2023, 115(3): 803-808.
35. 武凌宇, 白潇涵, 余静, 等. 双能CT细胞外容积分数在鉴别胰腺导管内乳头状黏液性肿瘤良恶性中的应用价值. 南京医科大学学报(自然科学版), 2023, 43(9): 1273-1278.
36. Kakizaki Y, Makino N, Tozawa T, et al. Stromal fibrosis and expression of matricellular proteins correlate with histological grade of intraductal papillary mucinous neoplasm of the pancreas. Pancreas, 2016, 45(8): 1145-1152.
37. 马娜, 李义兴, 徐一文, 等. 多层螺旋CT与MRI对胰腺神经内分泌肿瘤病理分级和肿瘤血供评估的前瞻性研究. 分子影像学杂志, 2023, 46(1): 129-134.
38. Iwaya H, Fukukura Y, Hashimoto S, et al. Prognostic significance of extracellular volume fraction with equilibrium contrast-enhanced computed tomography for pancreatic neuroendocrine neoplasms. Pancreatology, 2021, 21(4): 779-786.
39. Shubert CR, Wagie AE, Farnell MB, et al. Clinical risk score to predict pancreatic fistula after pancreatoduodenectomy: independent external validation for open and laparoscopic approaches. J Am Coll Surg, 2015, 221(3): 689-698.
40. Shi HY, Lu ZP, Li MN, et al. Dual-energy CT iodine concentration to evaluate postoperative pancreatic fistula after pancreatoduodenectomy. Radiology, 2022, 304(1): 65-72.
41. Zhu L, Sun Z, Dai M, et al. Tomoelastography and pancreatic extracellular volume fraction derived from MRI for predicting clinically relevant postoperative pancreatic fistula. J Magn Reson Imaging, 2023 May 20.
42. Sofue K, Ueshima E, Masuda A, et al. Estimation of pancreatic fibrosis and prediction of postoperative pancreatic fistula using extracellular volume fraction in multiphasic contrast-enhanced CT. Eur Radiol, 2022, 32(3): 1770-1780.
43. Steinkohl E, Olesen SS, Hansen TM, et al. T1 relaxation times and MR elastography-derived stiffness: new potential imaging biomarkers for the assessment of chronic pancreatitis. Abdom Radiol (NY), 2021, 46(12): 5598-5608.
44. Akisik MF, Sandrasegaran K, Jennings SG, et al. Diagnosis of chronic pancreatitis by using apparent diffusion coefficient measurements at 3.0-T MR following secretin stimulation. Radiology, 2009, 252(2): 418-425.
45. Liu Q, Zhang J, Jiang M, et al. Evaluating the histopathology of pancreatic ductal adenocarcinoma by intravoxel incoherent motion-diffusion weighted imaging comparing with diffusion-weighted imaging. Front Oncol, 2021, 11: 670085.
46. Hecht EM, Liu MZ, Prince MR, et al. Can diffusion-weighted imaging serve as a biomarker of fibrosis in pancreatic adenocarcinoma?. J Magn Reson Imaging, 2017, 46(2): 393-402.
47. Shi SY, Wang L, Peng Z, et al. Multi-frequency magnetic resonance elastography of the pancreas: measurement reproducibility and variance among healthy volunteers. Gastroenterol Rep (Oxf), 2022, 10: goac033.
48. 宋奇科, 钟时玲, 刘媛媛, 等. 磁共振弹性成像评价胰腺导管腺癌病理分级及生存期. 磁共振成像, 2022, 13(3): 26-30.
49. 熊晟原, 周星. 基于双层探测器光谱CT量化细胞外容积评估心肌组织学特性的研究进展. 中国医学影像学杂志, 2023, 31(3): 300-304.
50. 李庆阳, 张宇琦, 包佳琪, 等. 基于CT细胞外体积分数用于腹部疾病进展. 中国介入影像与治疗学, 2022, 19(12): 791-794.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Advances in study of extracellular volume fraction in pancreatic diseases

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