为了评估胰腺定量边缘分析与术后胰漏的发生率之间的相关性，对接受胰十二指肠切除术（PD）的患者进行了研究。研究对象包括在2018年3月至2019年11月期间接受PD的所有患者，并具备术前CT资料。利用自行开发的软件，在非对比扫描的胰体和胰尾（预期胰腺残留）边缘进行计算机辅助定量边缘分析，得到胰腺边缘分数(PMS)。同时还进行了术中胰腺触诊评估，将胰腺质地分为软质和非软质两类。通过未配对T检验比较不同组别的PMS值，并将其与术中胰腺质地评估以及根据国际胰腺外科研究组织（ISGPS）对术后胰漏分级进行相关分析。研究对象共包括200名患者（平均年龄64.6岁），其中146例术后未发生胰漏（73%，非胰漏组），54例发生胰漏（27%，胰漏组）。胰漏组与非胰漏组的PMS值存在显著差异（分别为1.88±0.05与0.69±0.01；p<0.0001）。术中被评估为"软质"质地的胰腺的PMS值显著高于被评估为"非软质"质地的胰腺（分别为1.21±0.04与0.73±0.02；p<0.0001）。在胰腺质地为软质（r=0.8016）和非软质（r=0.7602）的患者亚组中，PMS值与胰漏分级均存在显著相关性（均p<0.0001）。定量边缘分析可以通过特定软件对胰腺质地进行分层，从而可能改善术前风险评估和胰漏防治策略。该研究将定量胰腺边缘分析作为术后胰漏的预测因子，该检测方法具有高准确度，并与国际胰腺外科研究组织所定义的胰漏分级相关。• 胰十二指肠切除术后术后胰漏发生的风险预测仅基于术中评估。• 定量边缘分析可能在术前识别出高风险的胰漏患者。• 通过胰腺边缘分析对胰腺硬度进行定量化可以在术前CT中进行。© 2023.作者，欧洲放射学学会独家许可使用。

To assess the correlation between pancreatic quantitative edge analysis as a surrogate of parenchymal stiffness and the incidence of postoperative pancreatic fistula (POPF), in patients undergoing pancreaticoduodenectomy (PD).All consecutive patients who underwent PD at our Institution between March 2018 and November 2019 with an available preoperative CT were included. Pancreatic margin score (PMS) was calculated through computer-assisted quantitative edge analysis on the margins of the pancreatic body and tail (the expected pancreatic remnant) on non-contrast scans with in-house software. Intraoperative assessment of pancreatic stiffness by manual palpation was also performed, classifying pancreatic texture into soft and non-soft. PMS values were compared between groups using an unpaired T-test and correlated with the intraoperative evaluation of stiffness and with the grading of postoperative pancreatic fistula according to the International Study Group on Pancreatic Surgery (ISGPS).Patient population included 200 patients (mean age 64.6 years), 146 without onset of POPF (73%, non-POPF group), and 54 with POPF (27%, POPF group). A significant difference in PMS values was observed between POPF and non-POPF (respectively 1.88 ± 0.05 vs 0.69 ± 0.01; p < 0.0001). PMS values of pancreatic parenchymas intraoperatively considered "soft" were significantly higher than those evaluated as "non-soft" (1.21 ± 0.04 vs 0.73 ± 0.02; p < 0.0001). A significant correlation between PMS values and POPF grade was observed (r = 0.8316), even in subgroups of patients with soft (r = 0.8016) and non-soft (r = 0.7602) pancreas (all p < 0.0001).Quantitative edge analysis with dedicated software may stratify patients with different pancreatic stiffness, thus potentially improving preoperative risk assessment and strategies for POPF mitigation.This study proposes quantitative pancreas edge analysis as a predictor for postoperative pancreatic fistula. The test has high accuracy and correlation with fistula grade according to the International Study Group on Pancreatic Surgery.• Prediction of postoperative pancreatic fistula (POPF) onset risk after pancreaticoduodenectomy is based only on intraoperative evaluation. • Quantitative edge analysis may preoperatively identify patients with higher risk of POPF. • Quantification of pancreatic stiffness through the analysis of pancreatic margins could be done on preoperative CT.© 2023. The Author(s), under exclusive licence to European Society of Radiology.