Evaluation of pancreatic secretion after administration of secretin: application of magnetic resonance imaging.
BACKGROUND
To evaluate pancreatic exocrine function, we measured the changes in T2 enhanced hydrograhic intensity on magnetic resonance (MR) images of the pancreas following an injection of secretin, which is representative of the changes in duodenal fluid volume.


METHODS
The subjects were 10 patients with normal pancreatic function (N > 70% detected by using a pancreatic function diagnostant test) and 12 patients with hypo-function, including those with mild hypo-function (MH, 50-70%, six patients) and severe hypo-function (SH < 50%, six patients).


RESULTS
In the N group, T2 enhanced intensity of the pancreas increased to a maximum value (more than 10% compared with baseline) within 5 min of stimulation, then gradually decreased. No significant difference in the response was observed between the head and body of the pancreas. Changes in the MH group were similar to those of the N group. In contrast, significantly lower changes in T2 enhanced intensity were observed in SH group, relative to both the N and MH group (P < 0.05). The amount of secretin-induced increase in duodenal fluid after 16 min was not significantly different among the three groups. Furthermore, an evaluation of the residual pancreatic tissue after a pancreatoduodenectomy was also feasible.


CONCLUSIONS
Our results indicate that the MR-secretin test is useful for the evaluation of severe pancreatic exocrine dysfunction. The diagnostic test is simple, direct and non-invasive.
Nanashima
A
A
The First Department of Surgery, Nagasaki University School of Medicine, Nagasaki-shi, Japan. a-nanasm@alpha.med.nagasaki-u.ac.jp
Yamaguchi
H
H
Fukuda
T
T
Sakamoto
I
I
Kuroda
A
A
Sawai
T
T
Nakagoe
T
T
Ayabe
H
H
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000378:metabolism*; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D012633:Secretin; D018709:Statistics, Nonparametric
D012633:Secretin