Secretin-stimulated MRI assessment of exocrine pancreatic function in patients with cystic fibrosis and healthy controls.
Secretin-stimulated magnetic resonance imaging (s-MRI) and pancreatic diffusion weighted imaging (DWI) are novel non-invasive imaging techniques for assessment of exocrine pancreatic insufficiency (EPI). The aim was to validate s-MRI assessed pancreatic secreted volume using novel semi-automatic quantification software, and to assess the ability of s-MRI with DWI to diagnose EPI in patients with cystic fibrosis (CF).



s-MRI and DWI was performed in 19 patients with CF (median age 21 years; range 16-56; eight men) and in 10 healthy controls (HC) (median age 46 years; range 20-65; four men). Sequential coronal T2-weighted images covering the duodenum and small bowel and axial DWI were acquired before and 1, 5, 9, and 13 min after secretin stimulation. A short endoscopic secretin test was used as reference method for EPI.



CF patients with EPI had lower apparent diffusion coefficient before secretin in the pancreatic head (P < 0.001) and lower secreted bowel fluid volumes (P = 0.035) compared to HC and CF patients without EPI. ROC curve analyses identified that secreted fluid volume after 13 min yielded the highest diagnostic accuracy for diagnosing EPI (AUC 0.93; 95% CI [0.80-1.00]).



Pancreatic s-MRI is useful for the assessment of exocrine pancreatic function with high diagnostic accuracy for the diagnosis of EPI in CF.
Mech-Sense, Department of Radiology, Aalborg University Hospital, P.O. Box 365, 9100, Aalborg, Denmark. a.madzak@rn.dk.
Adnan
0000-0001-5363-1461
A
Madzak
Department of Clinical Medicine, University of Bergen, Mons, Norway.|Department of Medicine, Haukeland University Hospital, Mons, Norway.
Trond
T
Engjom
Department of Clinical Medicine, University of Bergen, Mons, Norway.|Department of Radiology, Haukeland University Hospital, Mons, Norway.
Gaute K
GK
Wathle
Centre for Pancreatic Diseases, Department of Gastroenterology & HepatologyAalborg University Hospital, Aalborg, Denmark.|Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Søren Schou
SS
Olesen
Department of Clinical Science, University of Bergen, Mons, Norway.|Pediatric Department, Haukeland University Hospital, Mons, Norway.
Erling
E
Tjora
Department of Clinical Science, University of Bergen, Mons, Norway.|Pediatric Department, Haukeland University Hospital, Mons, Norway.
Pål R
PR
Njølstad
Department of Clinical Science, University of Bergen, Mons, Norway.|Department of Thoracic Medicine, Haukeland University Hospital, Mons, Norway.
Birger Norderud
BN
Lærum
Centre for Pancreatic Diseases, Department of Gastroenterology & HepatologyAalborg University Hospital, Aalborg, Denmark.|Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Asbjørn Mohr
AM
Drewes
Department of Clinical Medicine, University of Bergen, Mons, Norway.|Department of Medicine, Haukeland University Hospital, Mons, Norway.
Georg
G
Dimcevski
Mech-Sense, Department of Radiology, Aalborg University Hospital, P.O. Box 365, 9100, Aalborg, Denmark.|Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Jens Brøndum
JB
Frøkjær
Department of Clinical Medicine, University of Bergen, Mons, Norway.|Department of Radiology, Haukeland University Hospital, Mons, Norway.
Ingfrid S
IS
Haldorsen
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003550:Cystic Fibrosis / Q000150:complications*; D010188:Exocrine Pancreatic Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012633:Secretin / Q000494:pharmacology*; D012984:Software
D012633:Secretin
Cystic fibrosis; DWI; Exocrine pancreatic insufficiency; Short endoscopic secretin test; s-MRI