Quantitative secretin MRCP (MRCPQ): results in 215 patients with known or suspected pancreatic pathology.
Secretin magnetic resonance cholangiopancreatography quantification (MRCPQ) of pancreatic exocrine function correlates well with steatorrhoea and conventional, non-invasive function tests. We report MRCPQ results in a variety of pancreatic conditions. A total of 215 patients [107 male, mean age 46 years (14-78)] were studied. A multi-slice MRCP sequence was performed before and at 2-min intervals after 0.1 ml/kg IV secretin. Change in small intestinal water volume was plotted against time and the flow rate derived from the gradient. Patients were classified using clinical history, MRCP, MR imaging, computed tomography (CT) [150/215 (70%)] and endoscopic retrograde cholangiopancreatography (ERCP) [56/215 (26%)] findings but not MRCPQ results. Mean, standard deviation and 95% confidence intervals were calculated. The one way ANOVA and Student's t-test were used for statistical analysis. Seventy-six patients had chronic pancreatitis, 26 were post-surgical, 34 post-acute pancreatitis, six atrophic pancreatopathy, eight with obstruction, 15 divisum, ten sphincter of Oddi dysfunction, 26 normal and 14 miscellaneous. Significant differences were observed between normals (mean+/-SD; 7.4 +/- 2.9 ml/min) and severe chronic pancreatitis (5.3 +/- 2.4) (P = 0.018), pancreatic atrophy (3.8 +/- 3.1) (P = 0.013) or duct obstruction (5.3 +/- 2.4) (P = 0.047)) and between moderate (7.0 +/- 3.0) (P = 0.03) and severe chronic pancreatitis. MRCPQ can be used to quantify function across the spectrum of pancreatic disease and showed significant differences between several different pathologies.
Gillams
A R
AR
Department of Medical Imaging, University College London Medical School and University College London Hospitals, London, UK. a.gillams@medphys.ucl.ac.ak
Lees
W R
WR
D000293:Adolescent; D000328:Adult; D000368:Aged; D049448:Cholangiopancreatography, Magnetic Resonance / Q000295:instrumentation* / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy; D010195:Pancreatitis / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy; D019047:Phantoms, Imaging; D011184:Postoperative Period; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome