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.

Pancreas Divisum and "Santorinicele": Diagnosis with Dynamic MR Cholangiopancreatography with Secretin Stimulation¹

¹ From the Departments of Radiology (R.M., M.G.B., S.S., G.M., A.V., P.M.) and Surgery (G.C., M.M.), A. Gemelli University Hospital, 8 Largo A. Gemelli, Rome, Italy 00168. From the 1999 RSNA scientific assembly. Received December 3, 1999; revision requested December 30; revision received February 14, 2000; accepted February 23. Address correspondence to R.M. (e-mail: rmanfredi@rm.unicatt.it).

PURPOSE: To evaluate the usefulness of magnetic resonance (MR) cholangiopancreatography (MRCP) before and after secretin administration in diagnosing santorinicele in patients with pancreas divisum.

MATERIALS AND METHODS: One hundred seven patients suspected of having pancreatic disease underwent MRCP before and after secretin administration (S-MRCP). S-MRCP images were evaluated for pancreas divisum and santorinicele and for size of the main pancreatic duct and santorinicele. The onset of duodenal filling was calculated on dynamic S-MRCP images.

RESULTS: Pancreas divisum was detected in five (5%) of 107 patients at MRCP and in 10 (9%) of 107 patients at S-MRCP. Santorinicele was detected in three (21%) of 14 patients at MRCP and in an additional four (seven [50%] of 14) patients at S-MRCP in patients with pancreas divisum. Santorinicele was confirmed in six of seven patients at endoscopic retrograde cholangiopancreatography (ERCP); in one of seven patients, ERCP was unsuccessful. The duct of Santorini was significantly (P < .05) larger in the pancreatic head in patients with pancreas divisum and santorinicele (3.6 mm) compared with those with only pancreas divisum (2.2 mm). A noteworthy reduction in size of the pancreatic duct (26%) and of the santorinicele (63%) was observed after sphincterotomy. The onset of duodenal filling was delayed significantly in patients with santorinicele (2.1 vs 1.3 minutes; P < .05).

CONCLUSION: S-MRCP helps in identifying pancreas divisum and santorinicele, which may be the cause of impeded pancreatic outflow.

Index terms: Endoscopic retrograde cholangiopancreatography (ERCP), 770.1222 • Magnetic resonance (MR), cholangiopancreatography, 770.121411, 770.121412, 770.121415 • Magnetic resonance (MR), comparative studies, 770.121411, 770.121412, 770.121415, 770.1222 • Pancreas, function • Pancreas, MR, 770.121411, 770.121412, 770.121415 • Pancreatic ducts, MR, 774.121411, 774.121412, 774.121415 • Pancreatitis, 770.291 • 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]

				K. J. Mortele, T. C. Rocha, J. L. Streeter, and A. J. Taylor Multimodality Imaging of Pancreatic and Biliary Congenital Anomalies RadioGraphics, May 1, 2006; 26(3): 715 - 731. [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. A. Soto, B. C. Lucey, and J. W. Stuhlfaut Pancreas Divisum: Depiction with Multi-Detector Row CT Radiology, May 1, 2005; 235(2): 503 - 508. [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]

				M. Kanematsu, M. Matsuo, Y. Shiratori, H. Kondo, H. Hoshi, I. Yasuda, and H. Moriwaki Thick-Section Half-Fourier Rapid Acquisition with Relaxation Enhancement MR Cholangiopancreatography: Effects of IV Administration of Gadolinium Chelate Am. J. Roentgenol., March 1, 2002; 178(3): 755 - 761. [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]

				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]