Hungarian Radiology

[Examination of pancreatic exocrine function with secretin stimulated magnetic resonance cholangiopancreatography]

ENDES János, CZAKÓ László, TAKÁCS Tamás, BODA Krisztina, LONOVICS János

OCTOBER 20, 2002

Hungarian Radiology - 2002;76(05)

[INTRODUCTION - The aim of this study was to assess the feasibility and usefulness of SS-MRPD for evaluation of the pancreatic exocrine function. PATIENTS AND METHODS - SS-MRPD was performed in 20 patients with mild (n=8) or severe (n=12) chronic pancreatitis (according to the grade of exocrine pancreatic insufficiency indicated by the Lundh test) and in 10 volunteers without pancreatic disease. MRPD images were evaluated before and 10 min after the iv. administration of 0.5 IU/kg secretin. The changes in pancreatic tissue T2 signal intensity and duodenal filling after the injection of secretin were determined by means of SS-MRPD. The SSMRPD findings were then compared with those of the Lundh test. RESULTS - The basal pancreatic T2 signal intensity was significantly higher in the patients with a mild or a severe exocrine pancreatic insufficiency as compared with the controls (826.5±36.36 and 908±80.51 vs 659.2±41.67). The pancreatic T2 signal intensity exhibited a significant elevation after secretin administration both in the volunteers and in the patients with mild or severe chronic pancreatitis. This elevation was significantly lower in both the mild and the severe chronic pancreatitis patients than in the volunteers (66.85±15.77 and 24.45±5.85, respectively, vs. 200.0± 45.07). After the administration of secretin, the diameter of the duodenum was significantly increased in all three groups. This duodenal filling was significantly reduced in patients with a mild or a severe exocrine pancreatic insufficiency as compared with the volunteers (4.12±1.33 and 1.70±0.77 vs. 15.38± 1.73). There was no significant difference in pancreatic T2 signal intensity changes or in duodenal filling in patients with a mild or a severe exocrine pancreatic insufficiency. There were significant correlations between the pancreatic T2 signal intensity changes and the duodenal filling and the results of the Lundh test (r= -0.616 and -0.78). CONCLUSION - These results demonstrate that the administration of secretin increases the T2 signal intensity of the pancreatic tissue and the diameter of the duodenum to different extents in normal subjects and in patients with chronic pancreatitis. This suggests that SS-MRPD can provide information of value in the assessment of an exocrine pancreatic insufficiency.]

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