HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Manfredi, R. Articles by Marano, P. Search for Related Content PubMed PubMed Citation Articles by Manfredi, R. Articles by Marano, P.

Severe Chronic Pancreatitis versus Suspected Pancreatic Disease: Dynamic MR Cholangiopancreatography after Secretin Stimulation¹

¹ From the Departments of Radiology (R.M., M.G.B., G.M., A.V., P.M.) and Surgery (G.C.), A. Gemelli University Hospital, 8 Largo A. Gemelli, Rome, Italy 00168; and the Department of Radiological Sciences (C.C.), G. D'Annunzio University, Chieti, Italy. Received November 30, 1998; revision requested December 30; final revision received June 14, 1999; accepted July 20. Address reprint requests to R.M. (e-mail: rmanfredi@rm.unicatt.it).

PURPOSE: To assess whether secretin stimulation improves visualization of the pancreatic ducts at magnetic resonance (MR) cholangiopancreatography (MRCP) in patients with severe chronic pancreatitis or suspected pancreatic disease.

MATERIALS AND METHODS: Thirty-one patients (group 1) with chronic pancreatitis and 84 patients (group 2) with clinical and/or laboratory findings suggestive of pancreatic disease who did not have ductal alterations at ultrasonography (US) and/or computed tomography (CT) underwent MRCP before and up to 10 minutes after secretin stimulation. Size of the main pancreatic duct (head, body, tail) and duodenal filling before and after secretin stimulation were measured quantitatively. Image quality, number of main pancreatic ductal segments visualized, visualization of side branches, ductal narrowing, endoluminal filling defects, and presence of pancreas divisum were analyzed qualitatively.

RESULTS: In both groups, the size of the main pancreatic duct increased significantly 3 minutes after secretin stimulation. Reduced duodenal filling was detected in patients with severe chronic pancreatitis (P < .001). The number of segments of the main pancreatic duct visualized improved from 85 (91%) to 93 (100%) of 93 in group 1 and from 164 (65%) to 245 (97%) of 252 (P < .001) in group 2. Visualization of side branches improved from 22 (71%) to 31 (100%) of 31 in group 1 and from three (4%) to 53 (63%) of 84 (P < .001) in group 2. Pancreas divisum was visualized in one additional patient in group 1 and in six additional patients in group 2.

CONCLUSION: The administration of secretin improves visualization of the pancreatic ducts and helps in the evaluation of exocrine reserve.

Index terms: Endoscopic retrograde cholangiopancreatography (ERCP) • Magnetic resonance (MR), rapid imaging, 73.121416, 770.121416 • Pancreas, function • Pancreas, MR, 770.121411, 770.121412, 770.121415 • Pancreatic ducts, MR, 774.121416, 774.297, 774.921 • Pancreatitis, 774.291 • Secretin

This article has been cited by other articles:

				M. F. Akisik, K. Sandrasegaran, A. A. Aisen, D. D. T. Maglinte, S. Sherman, and G. A. Lehman Dynamic secretin-enhanced MR cholangiopancreatography. RadioGraphics, May 1, 2006; 26(3): 665 - 677. [Abstract] [Full Text] [PDF]

				R. Tamura, T. Ishibashi, and S. Takahashi Chronic Pancreatitis: MRCP versus ERCP for Quantitative Caliber Measurement and Qualitative Evaluation Radiology, March 1, 2006; 238(3): 920 - 928. [Abstract] [Full Text] [PDF]

				J. Monill, J. Pernas, J. Clavero, A. Farre, A. Morales, M. Gonzalez, V. Artigas, and A. Martinez-Noguera Pancreatic Duct After Pancreatoduodenectomy: Morphologic and Functional Evaluation with Secretin-Stimulated MR Pancreatography Am. J. Roentgenol., November 1, 2004; 183(5): 1267 - 1274. [Abstract] [Full Text] [PDF]

				P D Thomas, A Forbes, J Green, P Howdle, R Long, R Playford, M Sheridan, R Stevens, R Valori, J Walters, et al. Guidelines for the investigation of chronic diarrhoea, 2nd edition Gut, July 1, 2003; 52(90005): v1 - 15. [Full Text]

				R. Manfredi, V. Lucidi, B. Gui, M. G. Brizi, A. Vecchioli, G. Maresca, L. Dall'Oglio, G. Costamagna, and P. Marano Idiopathic Chronic Pancreatitis in Children: MR Cholangiopancreatography after Secretin Administration Radiology, September 1, 2002; 224(3): 675 - 682. [Abstract] [Full Text] [PDF]

				K. J. Hellerhoff, H. Helmberger III, T. Rosch, M. R. Settles, T. M. Link, and E. J. Rummeny Dynamic MR Pancreatography After Secretin Administration: Image Quality and Diagnostic Accuracy Am. J. Roentgenol., July 1, 2002; 179(1): 121 - 129. [Abstract] [Full Text] [PDF]

				J. H. Kim, M.-J. Kim, S. I. Park, J.-J. Chung, S. Y. Song, H. S. Yoo, and J. T. Lee Using Kinematic MR Cholangiopancreatography to Evaluate Biliary Dilatation Am. J. Roentgenol., April 1, 2002; 178(4): 909 - 914. [Abstract] [Full Text] [PDF]

				C. Matos, O. Cappeliez, C. Winant, E. Coppens, J. Deviere, and T. Metens MR Imaging of the Pancreas: A Pictorial Tour RadioGraphics, January 1, 2002; 22(1): e2 - e2. [Abstract] [Full Text]

				R. Manfredi, G. Costamagna, M. G. Brizi, S. Spina, G. Maresca, A. Vecchioli, M. Mutignani, and P. Marano Pancreas Divisum and "Santorinicele": Diagnosis with Dynamic MR Cholangiopancreatography with Secretin Stimulation Radiology, November 1, 2000; 217(2): 403 - 408. [Abstract] [Full Text]

				Y. Fukukura, F. Fujiyoshi, M. Sasaki, and M. Nakajo Pancreatic Duct: Morphologic Evaluation with MR Cholangiopancreatography after Secretin Stimulation Radiology, March 1, 2002; 222(3): 674 - 680. [Abstract] [Full Text] [PDF]