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• Clinical Article •
Application value of virtual magnetic resonance elastography based on different DWI b-value combinations in assessing the severity of acute pancreatitis
XIONG Yuan  ZHENG Yulin  DENG Ping  SONG Xueliang  JIN Ming  LI Mei  ZHANG Xiaoming  LI Xinghui 

DOI:10.12015/issn.1674-8034.2026.05.013.


[Abstract] Objective To identify the optimal b-value combination for assessing pancreatic stiffness using virtual magnetic resonance elastography (vMRE) and to evaluate its application in assessing the severity of acute pancreatitis (AP).Materials and Methods Diffusion weighted imaging (DWI) images of the upper abdomen and clinical data from 137 AP patients and 55 healthy controls were retrospectively collected. Multi-b-value DWI scans were acquired at b = 50, 200, 600, 800, and 1500 s/mm2. High and low b-values were combined into five groups: 50/600, 50/800, 50/1500, 200/800, and 200/1500 s/mm2. Based on the signal intensities at the two different b-values, the virtual shear modulus (μdiff) was calculated using the formula: μdiff = α × In (SLKb/SHKb)/(HKb-LKb) + β. AP patients were further stratified according to the Atlanta classification, MR severity index (MRSI), and acute physiology and chronic health evaluation (APACHE) Ⅱ severity scores. The t-test or Mann-Whitney U test was used to compare pancreatic μdiff values between different b-value combinations within the AP group, as well as between the normal control group and the AP group for each b-value combination. Multiple linear regression analysis was performed to identify factors influencing pancreatic stiffness. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic performance of vMRE using different b-value combinations. For b-value combinations demonstrating diagnostic efficacy, Pearson and Spearman correlation analyses were further conducted to assess their correlation with AP severity grades.Results Within the AP group, no significant difference in pancreatic μdiff was found only between the b = 50/600 s/mm2 and b = 50/800 s/mm2 combinations (P > 0.05); significant differences were observed among all other b-value combinations (P < 0.05). Comparing AP patients and controls across different b-value combinations, significant differences in pancreatic μdiff were observed for the 50/1500 s/mm2 and 200/1500 s/mm2 combinations (P < 0.05). Multiple linear regression analysis showed confounding effects between BMI and hypertriglyceridemia (P < 0.05); therefore, both were included in the model for adjustment. After controlling for these factors, the AP group remained significantly and positively correlated with pancreatic μdiff (P < 0.05). Early intervention therapy, history of diabetes, fatty liver disease, and various etiological types (biliary, hyperlipidemic, alcoholic pancreatitis) showed no significant influence on pancreatic μdiff (P > 0.05). ROC curve analysis at different b-values showed that the area under the curve (AUC) for the 50/1500 s/mm2 combination was 0.757 (95% CI: 0.658 to 0.856), and for the 200/1500 s/mm2 combination was 0.809 (95% CI: 0.716 to 0.901). There was no statistically significant difference between the two AUCs (Z = 0.78, P > 0.05). Further correlation analysis indicated that the 200/1500 s/mm2 combination showed relatively higher correlations with the Atlanta classification, MRSI, and APACHE Ⅱ severity scores (r = 0.68, P < 0.01; r = 0.58, P < 0.01; r = 0.35, P < 0.05, respectively).Conclusion Pancreatic μdiff measured by vMRE using the 200/1500 s/mm2 combination shows the strongest correlation with AP severity. It can serve as a non-invasive, promising, and continuously quantitative imaging biomarker, providing a robust reference for the assessment of pancreatic stiffness and the grading of AP severity.
[Keywords] virtual magnetic resonance elastography；diffusion-weighted imaging；acute pancreatitis；multi-b-value combination；virtual shear modulus

XIONG Yuan1, 2   ZHENG Yulin1   DENG Ping1, 2   SONG Xueliang1, 2   JIN Ming1   LI Mei1   ZHANG Xiaoming1, 2   LI Xinghui1, 2*  

1 Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China

2 Sichuan Provincial Key Laboratory of Medical Imaging, Nanchong 637000, China

Corresponding author: LI X H, E-mail: Lixinghui1005@126.com

Conflicts of interest   None.

Received  2026-01-08
Accepted  2026-04-16
DOI: 10.12015/issn.1674-8034.2026.05.013
DOI:10.12015/issn.1674-8034.2026.05.013.

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