title: Does secretin add value in pediatric magnetic resonance cholangiopancreatography?
abstract: BACKGROUND
  Secretin--a hormone that stimulates pancreatic exocrine secretion--is described to improve visualization of the pancreatic duct by magnetic resonance cholangiopancreatography (MRCP). In our pediatric practice, however, we have not observed substantial benefit with the use of secretin.
  
  
  OBJECTIVE
  To determine whether secretin dilates and improves visualization of the pancreatic duct in pediatric MRCP.
  
  
  METHODS
  Retrospective evaluation of secretin-enhanced MRCPs performed over a 15-month period. One reviewer measured the pancreatic duct pre- and post-secretin and two reviewers, blinded to the administration of secretin, assessed image quality and subjective duct visibility. Similar assessments of the biliary tree served as internal controls.
  
  
  RESULTS
  We reviewed 20 MRCPs in 17 children. Following secretin administration, there was a small (0.3 mm) but statistically significant increase in pancreatic duct diameter (P = 0.002) and small (<0.2 mm) but significant increase in intrahepatic bile duct diameter (P = 0.0104). On subjective review, there was no significant difference in image quality or duct visibility based on the administration of secretin.
  
  
  CONCLUSIONS
  Secretin induces dilatation of the pancreatic duct but the value of that effect in pediatric MRCP is suspect given the small change in duct diameter and the lack of improvement in image quality and duct visibility.
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229, USA. andrew.trout@cchmc.org
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Trout
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Podberesky
authors.forename: Suraj D
authors.initials: SD
authors.lastname: Serai
authors.forename: Yan
authors.initials: Y
authors.lastname: Ren
authors.forename: Mekebib
authors.initials: M
authors.lastname: Altaye
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Towbin
mesh_terms: D000293:Adolescent; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D005260:Female; D005765:Gastrointestinal Agents; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D010182:Pancreatic Diseases / Q000473:pathology*; D010183:Pancreatic Ducts / Q000473:pathology*; D015203:Reproducibility of Results; D012633:Secretin / Q000008:administration & dosage; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
chemical_list: D005765:Gastrointestinal Agents; D012633:Secretin