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Does secretin-stimulated MRCP predict exocrine pancreatic insufficiency?: A comparison with noninvasive exocrine pancreatic function tests.
J Clin Gastroenterol. 2006 Oct; 40(9):851-5.JC

Abstract

BACKGROUND

Data on magnetic resonance cholangiopancreatography with secretin stimulation (S-MRCP) for the assessment of exocrine pancreatic insufficiency (EPI) are limited. We compared pancreatic function tests with the findings of S-MRCP in patients with chronic pancreatitis (CP) and disease controls.

METHODS

S-MRCP was performed in 23 patients (18 CP, 5 disease controls). MRCP images were analyzed for secretin-induced duodenal liquid filling (0=no filling; 1=duodenal bulb; 2=up to lower flexure; 3=beyond lower flexure). EPI was evaluated by fecal elastase, fecal fat concentration, and a 13C mixed chain triglyceride breath test. Clinically relevant EPI was stated if 2 of 3 tests were pathologic.

RESULTS

EPI was diagnosed in 10 of 18 patients with CP. Patients without EPI showed either grade 2 (n=4) or grade 3 (n=9) duodenal filling, whereas only 1/10 patients with EPI showed grade 3 duodenal filling. Sensitivity and specificity of S-MRCP for the diagnosis of EPI were 69% and 90%, respectively.

CONCLUSIONS

Assessment of duodenal filling should be performed in patients who undergo S-MRCP for the evaluation of pancreatic morphology. However, minor degrees of duodenal filling are equivocal and require further diagnostic evaluation.

Authors+Show Affiliations

Medical Department I-ZAFES, Johann Wolfgang Goethe-University Frankfurt am Main, Germany. arne.schneider@em.uni-frankfurt.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17016144

Citation

Schneider, Arne R J., et al. "Does Secretin-stimulated MRCP Predict Exocrine Pancreatic Insufficiency?: a Comparison With Noninvasive Exocrine Pancreatic Function Tests." Journal of Clinical Gastroenterology, vol. 40, no. 9, 2006, pp. 851-5.
Schneider AR, Hammerstingl R, Heller M, et al. Does secretin-stimulated MRCP predict exocrine pancreatic insufficiency?: A comparison with noninvasive exocrine pancreatic function tests. J Clin Gastroenterol. 2006;40(9):851-5.
Schneider, A. R., Hammerstingl, R., Heller, M., Povse, N., Murzynski, L., Vogl, T. J., Caspary, W. F., & Stein, J. (2006). Does secretin-stimulated MRCP predict exocrine pancreatic insufficiency?: A comparison with noninvasive exocrine pancreatic function tests. Journal of Clinical Gastroenterology, 40(9), 851-5.
Schneider AR, et al. Does Secretin-stimulated MRCP Predict Exocrine Pancreatic Insufficiency?: a Comparison With Noninvasive Exocrine Pancreatic Function Tests. J Clin Gastroenterol. 2006;40(9):851-5. PubMed PMID: 17016144.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does secretin-stimulated MRCP predict exocrine pancreatic insufficiency?: A comparison with noninvasive exocrine pancreatic function tests. AU - Schneider,Arne R J, AU - Hammerstingl,Renate, AU - Heller,Matthias, AU - Povse,Nada, AU - Murzynski,Lydia, AU - Vogl,Thomas J, AU - Caspary,Wolfgang F, AU - Stein,Juergen, PY - 2006/10/4/pubmed PY - 2007/1/11/medline PY - 2006/10/4/entrez SP - 851 EP - 5 JF - Journal of clinical gastroenterology JO - J Clin Gastroenterol VL - 40 IS - 9 N2 - BACKGROUND: Data on magnetic resonance cholangiopancreatography with secretin stimulation (S-MRCP) for the assessment of exocrine pancreatic insufficiency (EPI) are limited. We compared pancreatic function tests with the findings of S-MRCP in patients with chronic pancreatitis (CP) and disease controls. METHODS: S-MRCP was performed in 23 patients (18 CP, 5 disease controls). MRCP images were analyzed for secretin-induced duodenal liquid filling (0=no filling; 1=duodenal bulb; 2=up to lower flexure; 3=beyond lower flexure). EPI was evaluated by fecal elastase, fecal fat concentration, and a 13C mixed chain triglyceride breath test. Clinically relevant EPI was stated if 2 of 3 tests were pathologic. RESULTS: EPI was diagnosed in 10 of 18 patients with CP. Patients without EPI showed either grade 2 (n=4) or grade 3 (n=9) duodenal filling, whereas only 1/10 patients with EPI showed grade 3 duodenal filling. Sensitivity and specificity of S-MRCP for the diagnosis of EPI were 69% and 90%, respectively. CONCLUSIONS: Assessment of duodenal filling should be performed in patients who undergo S-MRCP for the evaluation of pancreatic morphology. However, minor degrees of duodenal filling are equivocal and require further diagnostic evaluation. SN - 0192-0790 UR - https://www.unboundmedicine.com/medline/citation/17016144/Does_secretin_stimulated_MRCP_predict_exocrine_pancreatic_insufficiency:_A_comparison_with_noninvasive_exocrine_pancreatic_function_tests_ DB - PRIME DP - Unbound Medicine ER -