title: Evaluation of Qualitative Magnetic Resonance Imaging Features for Diagnosis of Chronic Pancreatitis.
abstract: OBJECTIVE
  The purpose of this study was to determine qualitative pancreatic magnetic resonance imaging (MRI) features that must be present to predict abnormal pancreatic secretory function in patients evaluated for chronic pancreatitis (CP).
  
  
  METHODS
  The MRIs of study subjects were reviewed by 2 abdominal radiologists; qualitative parenchyma and ductal features were recorded. Endoscopic pancreatic function test (ePFT) results (reference standard) were classified as normal (peak pancreatic fluid bicarbonate [HCO3-] ≥75 meq/L) or abnormal (<75). Abnormal ePFT was further classified as mild/moderate (74-65) and marked deficiency (<65). Statistical analysis was performed to assess the association between MRI features and abnormal ePFT.
  
  
  RESULTS
  The study cohort was composed of 93 subjects, mean age 49 years (range, 18-78 years), 65% females. Univariate analysis identified 9 qualitative MRI features significantly (P < 0.05) associated with abnormal pancreatic secretory function. Number of MRI features increases as peak pancreatic fluid [HCO3-] decreases (Pearson r = -0.629; P = 0.001). Receiver operating characteristic curve analysis determined that a threshold of 6 or more associated MRI features 64% sensitive and 94% specific for marked bicarbonate deficiency.
  
  
  CONCLUSIONS
  Qualitative MRI parenchymal and ductal features are associated with CP. Presence of 6 or more features results in a higher specificity for the diagnosis of CP in advanced disease.
authors.affiliation: From the *Division of Abdominal Imaging and Intervention, Department of Radiology, and †Division of Gastroenterology, Hepatology and Endoscopy Center for Pancreatic Disease, Department of Medicine, Brigham and Women's Hospital, and ‡Abdominal Imaging and Body MRI, Department of Radiology, Beth Israel Deaconess Medical Center, and §Center for Clinical Investigation, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Nisha I
authors.initials: NI
authors.lastname: Sainani
authors.forename: Vivek
authors.initials: V
authors.lastname: Kadiyala
authors.forename: Koenraad
authors.initials: K
authors.lastname: Mortele
authors.forename: Linda
authors.initials: L
authors.lastname: Lee
authors.forename: Shadeah
authors.initials: S
authors.lastname: Suleiman
authors.forename: Jessica
authors.initials: J
authors.lastname: Rosenblum
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Peter A
authors.initials: PA
authors.lastname: Banks
authors.forename: Darwin L
authors.initials: DL
authors.lastname: Conwell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001639:Bicarbonates / Q000378:metabolism; D015331:Cohort Studies; D004724:Endoscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D010186:Pancreatic Function Tests / Q000379:methods*; D010189:Pancreatic Juice / Q000378:metabolism; D050500:Pancreatitis, Chronic / Q000175:diagnosis*; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D001639:Bicarbonates