Secretin-stimulated MR cholangio-pancreatography in the evaluation of asymptomatic patients with non-specific pancreatic hyperenzymemia.
OBJECTIVE
To assess the diagnostic value of secretin-stimulated MRCP (SS-MRCP) compared with conventional MRCP in asymptomatic patients with mild elevations of pancreatic enzymes.


METHODS
Eighty asymptomatic patients with pancreatic hyperenzymemia underwent MR imaging at 1.5T-device (Signa EXCITE, GE Healthcare). After the acquisition of axial T1w,T2w sequences, and conventional MRCP, SS-MRCP was performed using a single-slice coronal breath-hold, thick-slab, SSFSE T2w sequence, repeated every 30s up to 15 min following intravenous injection of secretin (Secrelux, Sanochemia).


RESULTS
On the basis of the standards of reference, our final diagnoses were: negative findings (n=23), pancreas divisum (n=22), mild chronic pancreatitis (n=14), inflammatory ampullary stenosis (n=3), juxtapapillary duodenal diverticulum (n=1), small cystic lesions (<1cm) (n=22; 5/22 cases associated with pancreas divisum). The image quality of SS-MRCP was significantly higher than that of conventional MRCP (p<0.0001). Standards of reference did not differ significantly from of SS-MRCP findings (p=0.5), while was statistically different from those of conventional MRCP (p<0.0001). A significant difference was found between conventional MRCP and SS-MRCP findings (p<0.0001).


CONCLUSIONS
In asymptomatic patients with non-specific pancreatic hyperenzymemia SS-MRCP may represent the best non-invasive diagnostic technique, since it gives morphological and functional information.
Donati
Francescamaria
F
2nd Department of Radiology, Pisa University-Hospital, Via Paradisa 2, I-56124 Pisa, Italy. fra.donati@katamail.com
Boraschi
Piero
P
Gigoni
Roberto
R
Salemi
Simonetta
S
Faggioni
Lorenzo
L
Bertucci
Cristina
C
Cecchi
Claudia
C
Bartolozzi
Carlo
C
Falaschi
Fabio
F
D000328:Adult; D000368:Aged; D014670:Ampulla of Vater; D000681:Amylases / Q000097:blood; D049448:Cholangiopancreatography, Magnetic Resonance; D003137:Common Bile Duct Diseases / Q000175:diagnosis; D003251:Constriction, Pathologic; D004240:Diverticulum / Q000175:diagnosis; D004378:Duodenal Diseases / Q000175:diagnosis; D005260:Female; D006801:Humans; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000002:abnormalities / Q000187:drug effects / Q000201:enzymology*; D010182:Pancreatic Diseases / Q000175:diagnosis; D010186:Pancreatic Function Tests; D050500:Pancreatitis, Chronic / Q000175:diagnosis; D012633:Secretin
D012633:Secretin; D008049:Lipase; D000681:Amylases