Imaging characteristics and related factors of pancreatic atrophy after steroid therapy in autoimmune pancreatitis

GONG Ming; DAI Na; GENG Dandan; HUO Jianwei; JIN Erhu; ZHANG Binbin

doi:10.19300/j.2025.L21392

Abstract：Objective To explore the CT and MRI features of pancreatic atrophy after steroid induced remission treatment in autoimmune pancreatitis(AIP)and analyze the related influencing factors of pancreatic atrophy.Methods Clinical and imaging data of 59 patients with AIP were retrospectively collected.Based on whether pancreatic atrophy occurred after steroid treatment,patients were divided into a pancreatic atrophy group(21 cases)and a pancreatic non-atrophy group(38 cases).Kaplan-Meier curve was used to estimate the cumulative pancreatic atrophy rate.The t-test,Mann Whitney U test,and chi square test were used to compare the differences in clinical and imaging features between the two groups.Univariate and multivariate logistic regression were used to identify the influence factors for pancreatic atrophy in AIP.Results After steroid treatment,imaging examinations showed that among the 21 patients in the pancreatic atrophy group,16 exhibited uniform atrophy of the entire pancreas,while 5 showed segmental atrophy in the body and tail of pancreas.The cumulative pancreatic atrophy rate at 12,24,36,48,and 60 months post-treatment were 16.9％,27.6％,35.5％,40.8％,and 48.2％,respectively.There were statistically significant differences in age,poor blood glucose control after steroid treatment,follow-up duration,and maximum thickness of the pancreatic body between the two groups(P＜0.05).Univariate and multivariate analysis showed that age[OR=1.143(1.036-1.261)],follow-up duration[OR=1.037(1.006-1.069)],and smoking history[OR=5.031(1.326-19.087)]were independent influencing factors for pancreatic atrophy.Conclusions Pancreatic atrophy following steroid treatment in AIP typically presents as uniform atrophy of the entire parenchyma,with fewer cases exhibiting pancreatic calcification or pancreatic duct dilation.Age,follow-up duration,and smoking history are independent influence factors for this condition.