title: Magnetic resonance imaging and magnetic resonance cholangiopancreatography findings compared with fecal elastase 1 measurement for the diagnosis of chronic pancreatitis.
abstract: OBJECTIVE
  To correlate magnetic resonance cholangiopancreatography (MRCP) and magnetic resonance imaging (MRI) findings of the pancreas with the pancreatic exocrine function determined by fecal elastase 1 concentration.
  
  
  METHODS
  Magnetic resonance imaging and MRCP findings of 81 consecutive patients with clinically suspected chronic pancreatitis and 21 healthy volunteers were evaluated. All subjects underwent MRI/MRCP and fecal elastase 1 testing within 1 to 4 weeks' interval. Magnetic resonance cholangiopancreatography images were evaluated according to Cambridge classification. Magnetic resonance imaging of the pancreas was assessed for pancreatic size, signal, and arterial enhancement.
  
  
  RESULTS
  All volunteers had normal fecal elastase 1 levels (>200 microg/g) and normal MRI/MRCP findings. Thirty-one of 56 patients revealed MRI and/or MRCP findings despite normal fecal elastase 1 concentration. Four of 25 patients revealed normal MRI and MRCP findings despite low fecal elastase 1 concentration (<200 microg/g). Magnetic resonance imaging findings of size (P = 0.00001), arterial enhancement (P = 0.00001), and parenchymal signal (P = 0.001) were significantly different among the control group, patients with normal fecal elastase 1 levels, and patients with low fecal elastase 1 levels. Magnetic resonance cholangiopancreatography findings (P = 0.00001), pancreatic size (P = 0.00001), arterial enhancement (P = 0.014), and parenchymal signal (P = 0.004) on MRI correlated with the fecal elastase 1 concentration.
  
  
  CONCLUSIONS
  Magnetic resonance imaging/MRCP findings correlate with fecal elastase 1 concentration and may precede pancreatic exocrine insufficiency in the early stages of chronic pancreatitis.
authors.affiliation: Department of Radiology, University Hospital Giessen and Marburg, Giessen, Germany.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bilgin
authors.forename: Sabriye
authors.initials: S
authors.lastname: Bilgin
authors.forename: N Cem
authors.initials: NC
authors.lastname: Balci
authors.forename: Amir Javad
authors.initials: AJ
authors.lastname: Momtahen
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Bilgin
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Klör
authors.forename: Wigbert S
authors.initials: WS
authors.lastname: Rau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D049448:Cholangiopancreatography, Magnetic Resonance; D005243:Feces / Q000201:enzymology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology; D010183:Pancreatic Ducts / Q000473:pathology; D010196:Pancreatic Elastase / Q000032:analysis*; D050500:Pancreatitis, Chronic / Q000175:diagnosis* / Q000473:pathology
chemical_list: D010196:Pancreatic Elastase