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Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging.
Hepatobiliary Pancreat Dis Int. 2008 Apr; 7(2):192-5.HP

Abstract

BACKGROUND

Magnetic resonance cholangiopancreatography (MRCP) is useful to assess exocrine pancreatic function by combining rapid imaging acquisition with the administration of secretin, a gastrointestinal hormone that stimulates the secretion of bile and pancreatic juice. However, extensive data on this method are lacking. This study aimed to determine whether MRCP with secretin administration is able to simultaneously detect alterations of both the pancreatic ducts and exocrine pancreatic function.

METHODS

All subjects older than 18 years who underwent magnetic resonance imaging (MRI) and cholangio-Wirsung magnetic resonance imaging (CWMRI) for suspicion of benign or malignant pancreatic diseases from January 2006 to December 2006 were enrolled in the study. MRI and CWMRI were carried out using a dedicated apparatus.

RESULTS

Eighty-seven patients (46 males, 41 females, mean age 59.7+/-14.6, range 27-87 years) were enrolled. Of the 87 patients, 39 had a normal pancreas on imaging, 20 had an intrapapillary mucinous tumor (IPMT), and the rest had chronic pancreatitis (7), serous cystadenoma (6), a previous attack of acute biliary pancreatitis (5), congenital ductal abnormalities (5), mucinous cystadenoma (3), previous pancreatic head resection for autoimmune pancreatitis (1), or cholangiocarcinoma (1). Morphologically, we found two pseudocysts (one of the 7 patients with chronic pancreatitis, and one of the 5 patients after an attack of acute pancreatitis; the latter pseudocyst communicated with the main pancreatic duct). Calcifications were found in 3 of the 7 patients with chronic pancreatitis. All patients with IPMT and mucinous cystadenoma and 3 patients with serous cystadenoma were histologically confirmed. The remaining patients were followed up adequately to confirm the diagnosis by imaging. According to the Matos criteria, 73 patients (83.9%) were of grade 3, 8 grade 2, 4 grade 1, and 2 grade 0. The only pancreatic diseases which impaired the exocrine pancreatic secretion stimulated by secretin were chronic pancreatitis (57.1% of the patients, grade 0-1) and the IPMT mixed type in 2 of the 4 patients was grade 1.

CONCLUSION

Secretin MRCP is a useful technique to simultaneously detect the presence of alterations of the pancreatic ducts and exocrine pancreatic function.

Authors+Show Affiliations

Department of Radiology, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, Bologna, Italy.No 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

18397857

Citation

Calculli, Lucia, et al. "Exocrine Pancreatic Function Assessed By Secretin cholangio-Wirsung Magnetic Resonance Imaging." Hepatobiliary & Pancreatic Diseases International : HBPD INT, vol. 7, no. 2, 2008, pp. 192-5.
Calculli L, Pezzilli R, Fiscaletti M, et al. Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging. Hepatobiliary Pancreat Dis Int. 2008;7(2):192-5.
Calculli, L., Pezzilli, R., Fiscaletti, M., Casadei, R., Brindisi, C., & Gavelli, G. (2008). Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging. Hepatobiliary & Pancreatic Diseases International : HBPD INT, 7(2), 192-5.
Calculli L, et al. Exocrine Pancreatic Function Assessed By Secretin cholangio-Wirsung Magnetic Resonance Imaging. Hepatobiliary Pancreat Dis Int. 2008;7(2):192-5. PubMed PMID: 18397857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging. AU - Calculli,Lucia, AU - Pezzilli,Raffaele, AU - Fiscaletti,Marta, AU - Casadei,Riccardo, AU - Brindisi,Carla, AU - Gavelli,Giampaolo, PY - 2008/4/10/pubmed PY - 2008/8/30/medline PY - 2008/4/10/entrez SP - 192 EP - 5 JF - Hepatobiliary & pancreatic diseases international : HBPD INT JO - Hepatobiliary Pancreat Dis Int VL - 7 IS - 2 N2 - BACKGROUND: Magnetic resonance cholangiopancreatography (MRCP) is useful to assess exocrine pancreatic function by combining rapid imaging acquisition with the administration of secretin, a gastrointestinal hormone that stimulates the secretion of bile and pancreatic juice. However, extensive data on this method are lacking. This study aimed to determine whether MRCP with secretin administration is able to simultaneously detect alterations of both the pancreatic ducts and exocrine pancreatic function. METHODS: All subjects older than 18 years who underwent magnetic resonance imaging (MRI) and cholangio-Wirsung magnetic resonance imaging (CWMRI) for suspicion of benign or malignant pancreatic diseases from January 2006 to December 2006 were enrolled in the study. MRI and CWMRI were carried out using a dedicated apparatus. RESULTS: Eighty-seven patients (46 males, 41 females, mean age 59.7+/-14.6, range 27-87 years) were enrolled. Of the 87 patients, 39 had a normal pancreas on imaging, 20 had an intrapapillary mucinous tumor (IPMT), and the rest had chronic pancreatitis (7), serous cystadenoma (6), a previous attack of acute biliary pancreatitis (5), congenital ductal abnormalities (5), mucinous cystadenoma (3), previous pancreatic head resection for autoimmune pancreatitis (1), or cholangiocarcinoma (1). Morphologically, we found two pseudocysts (one of the 7 patients with chronic pancreatitis, and one of the 5 patients after an attack of acute pancreatitis; the latter pseudocyst communicated with the main pancreatic duct). Calcifications were found in 3 of the 7 patients with chronic pancreatitis. All patients with IPMT and mucinous cystadenoma and 3 patients with serous cystadenoma were histologically confirmed. The remaining patients were followed up adequately to confirm the diagnosis by imaging. According to the Matos criteria, 73 patients (83.9%) were of grade 3, 8 grade 2, 4 grade 1, and 2 grade 0. The only pancreatic diseases which impaired the exocrine pancreatic secretion stimulated by secretin were chronic pancreatitis (57.1% of the patients, grade 0-1) and the IPMT mixed type in 2 of the 4 patients was grade 1. CONCLUSION: Secretin MRCP is a useful technique to simultaneously detect the presence of alterations of the pancreatic ducts and exocrine pancreatic function. SN - 1499-3872 UR - https://www.unboundmedicine.com/medline/citation/18397857/Exocrine_pancreatic_function_assessed_by_secretin_cholangio_Wirsung_magnetic_resonance_imaging_ L2 - https://medlineplus.gov/pancreaticdiseases.html DB - PRIME DP - Unbound Medicine ER -