الفهرس 
Embryologic developmentOnly 14 pages are availabe for public view
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Abstract
The pancreas plays a key role in diabetes mellitus, a progressive disease characterized by chronic hyperglycemia in the context of insulin resistance and/or beta cell dysfunction and death. Recently, various studies had investigated the relation between the change in the pancreatic volume, fat content and the future development of type 2 diabetes mellitus. It is thought that fat accumulation in the pancreas and decreased its size can influence pancreatic function in which it can predispose to insulin resistance or B-cell dysfunction. The use of various imaging studies is expected to produce reliable information regarding assessment of these pancreatic parameters, to provide better, more convenient diagnostic alternatives rather than the needle biopsy techniques, which had relatively higher incidence of procedural complications, so ultrasonography, CT and MRI were tried. The aim of the current study was to assess the value of multi-detector computed tomography in estimation of pancreatic volume and fat content as well as the relation between these parameters and the development of type 2 diabetes. This study was done in CT unit at Tanta university Diagnostic Radiology & Medical Imaging department, and Internal Medicine Department, in which 40 subjects were recruited (their age ranged from 21 to 60), 10 of them were selected as a control group, and 30 patients were selected as a diabetic group with type 2 diabetes proven clinically and confirmed by laboratory investigations which was done to every selected subject, including OGTT, FBG, PG120 and HbA1C, these previous laboratory parameters were correlated to the pancreatic volume and fat contents in every subject, which were obtained and assessed using multi-detector-row computed tomography with 320 detector-row scanner, before and after IV contrast injection. Pancreatic volume was measured in (cm3) on axial contrast images using summation of area technique in which the boundary of the pancreatic parenchyma was outlined using the free selection tool, then using the volumetric ability installed on the DICOM viewer software to measure the volume of the selected region in each slide, then the pancreatic volume was determined by the summation of the segmented pancreatic area multiplied by the slice interval (3 mm) in each slice. Pancreatic fat was measured in unenhanced images by detecting difference of HU measures between the pancreas and the spleen (HUp-s). According to the results, it was notable that the T2D group had relatively smaller pancreatic sizes (mean value of 49.97 ±3.40 cm3), higher pancreatic fat content (mean value of -5.49 ±1.28 HU), and higher laboratory findings to confirm the presenting diabetic history. However, the control group had relatively larger pancreatic sizes (mean value of 63.80 ±5.16 cm3), lower pancreatic fat content (mean value of -2.43 ±0.67 HU), and normal laboratory findings confirming the presenting non-diabetic state. In conclusion, the present study suggests that pancreatic volume and fat deposition may contribute to the development of type 2 diabetes, and that measuring pancreatic volume and fat content will be helpful to prove the change in their parameters as a cause of the development of diabetes and for screening individuals at high risk. We recommend adding pancreatic volumetry and fat content measurement by the previously discussed techniques to the contrast enhanced abdominal CT study protocols, especially for individuals at risk of developing type 2 diabetes, for prediction of any upcoming expected insulin resistance, which may progress by time to type 2 diabetes, and redirect those with positive imaging findings to the internal medicine department for further clinical and laboratory diagnostic approaches.