title: Anatomic variants of the pancreatic duct and their clinical relevance: an MR-guided study in the general population.
abstract: OBJECTIVE
  To investigate the frequency of pancreatic duct (PD) variants and their effect on pancreatic exocrine function in a population-based study using non-invasive secretin-stimulated magnetic resonance cholangiopancreatography (sMRCP).
  
  
  METHODS
  Nine hundred and ninety-five volunteers, 457 women and 538 men, aged 51.9 ± 13.4 years, underwent navigator-triggered, T2-weighted, 3D turbo spin echo MRCP on a 1.5 T system after 1 unit/kg secretin administration. Two readers evaluated images for PD variants. Pancreatic exocrine function and morphological signs of chronic pancreatitis such as abnormalities of the main PD, side branch dilatation, and pancreatic cysts were evaluated and related to PD variants using a Kruskal-Wallis test and post hoc analysis.
  
  
  RESULTS
  Of all sMRCP, 93.2% were of diagnostic quality. Interobserver reliability for detection of PD variants was found to be kappa 0.752 (95 %CI, 0.733 - 0.771). Normal PD variants were observed in 90.4% (n = 838/927). Variants of pancreas divisum was identified in 9.6% (n = 89/927). Abnormalities of the main PD, side branch dilatation, and pancreatic cysts were observed in 2.4%, 16.6%, and 27.7%, respectively, and were not significantly different between pancreas divisum and non-divisum group (P = 0.122; P = 0.152; P = 0.741). There was no association between PD variants and pancreatic exocrine function (P = 0.367).
  
  
  CONCLUSIONS
  PD variants including pancreas divisum are not associated with morphological signs of chronic pancreatitis or restriction of pancreatic exocrine function.
  
  
  CONCLUSIONS
  MRCP allows the evaluation of pancreatic duct variants and morphological change. Pancreatic duct variants are not associated with morphological signs of chronic pancreatitis. Pancreas divisum is not accompanied by restriction of pancreatic exocrine function. Pancreatic duct variants including pancreas divisum are limited in their clinical relevance.
authors.affiliation: Department of Radiology and Neuroradiology, University Medicine, Ernst Moritz Arndt University Greifswald, Ferdinand-Sauerbruch-Straße 1, Greifswald, 17475, Germany, buelowr@uni-greifswald.de.
authors.forename: Robin
authors.initials: R
authors.lastname: Bülow
authors.forename: Peter
authors.initials: P
authors.lastname: Simon
authors.forename: Robert
authors.initials: R
authors.lastname: Thiel
authors.forename: Patrick
authors.initials: P
authors.lastname: Thamm
authors.forename: Philip
authors.initials: P
authors.lastname: Messner
authors.forename: Markus M
authors.initials: MM
authors.lastname: Lerch
authors.forename: Julia
authors.initials: J
authors.lastname: Mayerle
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Norbert
authors.initials: N
authors.lastname: Hosten
authors.forename: Jens-Peter
authors.initials: JP
authors.lastname: Kühn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods; D004065:Digestive System Abnormalities / Q000175:diagnosis / Q000453:epidemiology; D004108:Dilatation, Pathologic / Q000473:pathology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology; D046790:Pancreas, Exocrine / Q000502:physiology; D010181:Pancreatic Cyst / Q000175:diagnosis; D010183:Pancreatic Ducts / Q000002:abnormalities*; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D015203:Reproducibility of Results; D012633:Secretin; D055815:Young Adult
chemical_list: D012633:Secretin