Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging

Lucia Calculli, Raffaele Pezzilli, Marta Fiscaletti, Riccardo Casadei, Carla Brindisi, Giampaolo Gavelli

Research output: Contribution to journalArticle

Abstract

Background: Magnetic resonance cholangiopancreatography (MRCP) is useful to assess exocrine pancreatic function by combining rapid imaging acquisition with the administration of secretin, a gastrointestinal hormone that stimulates the secretion of bile and pancreatic juice. However, extensive data on this method are lacking. This study aimed to determine whether MRCP with secretin administration is able to simultaneously detect alterations of both the pancreatic ducts and exocrine pancreatic function. Methods: All subjects older than 18 years who underwent magnetic resonance imaging (MRI) and cholangio-Wirsung magnetic resonance imaging (CWMRI) for suspicion of benign or malignant pancreatic diseases from January 2006 to December 2006 were enrolled in the study. MRI and CWMRI were carried out using a dedicated apparatus. Results: Eighty-seven patients (46 males, 41 females, mean age 59.7±14.6, range 27-87 years) were enrolled. Of the 87 patients, 39 had a normal pancreas on imaging, 20 had an intrapapillary mucinous tumor (IPMT), and the rest had chronic pancreatitis (7), serous cystadenoma (6), a previous attack of acute biliary pancreatitis (5), congenital ductal abnormalities (5), mucinous cystadenoma (3), previous pancreatic head resection for autoimmune pancreatitis (1), or cholangiocarcinoma (1). Morphologically, we found two pseudocysts (one of the 7 patients with chronic pancreatitis, and one of the 5 patients after an attack of acute pancreatitis; the latter pseudocyst communicated with the main pancreatic duct). Calcifications were found in 3 of the 7 patients with chronic pancreatitis. All patients with IPMT and mucinous cystadenoma and 3 patients with serous cystadenoma were histologically confirmed. The remaining patients were followed up adequately to confirm the diagnosis by imaging. According to the Matos criteria, 73 patients (83.9%) were of grade 3, 8 grade 2, 4 grade 1, and 2 grade 0. The only pancreatic diseases which impaired the exocrine pancreatic secretion stimulated by secretin were chronic pancreatitis (57.1% of the patients, grade 0-1) and the IPMT mixed type in 2 of the 4 patients was grade 1. Conclusion: Secretin MRCP is a useful technique to simultaneously detect the presence of alterations of the pancreatic ducts and exocrine pancreatic function.

Original languageEnglish
Pages (from-to)192-195
Number of pages4
JournalHepatobiliary and Pancreatic Diseases International
Volume7
Issue number2
Publication statusPublished - Apr 2008

Fingerprint

Secretin
Magnetic Resonance Imaging
Chronic Pancreatitis
Magnetic Resonance Cholangiopancreatography
Pancreatic Ducts
Serous Cystadenoma
Mucinous Cystadenoma
Pancreatitis
Pancreatic Diseases
Gastrointestinal Hormones
Pancreatic Juice
Neoplasms
Cholangiocarcinoma
Bile
Pancreas

Keywords

  • Cholangiopancreatography
  • Chronic pancreatitis
  • Magnetic resonance
  • Pancreatic insufficiency
  • Pancreatic neoplasms

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Calculli, L., Pezzilli, R., Fiscaletti, M., Casadei, R., Brindisi, C., & Gavelli, G. (2008). Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging. Hepatobiliary and Pancreatic Diseases International, 7(2), 192-195.

Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging. / Calculli, Lucia; Pezzilli, Raffaele; Fiscaletti, Marta; Casadei, Riccardo; Brindisi, Carla; Gavelli, Giampaolo.

In: Hepatobiliary and Pancreatic Diseases International, Vol. 7, No. 2, 04.2008, p. 192-195.

Research output: Contribution to journalArticle

Calculli, L, Pezzilli, R, Fiscaletti, M, Casadei, R, Brindisi, C & Gavelli, G 2008, 'Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging', Hepatobiliary and Pancreatic Diseases International, vol. 7, no. 2, pp. 192-195.
Calculli L, Pezzilli R, Fiscaletti M, Casadei R, Brindisi C, Gavelli G. Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging. Hepatobiliary and Pancreatic Diseases International. 2008 Apr;7(2):192-195.
Calculli, Lucia ; Pezzilli, Raffaele ; Fiscaletti, Marta ; Casadei, Riccardo ; Brindisi, Carla ; Gavelli, Giampaolo. / Exocrine pancreatic function assessed by secretin cholangio-Wirsung magnetic resonance imaging. In: Hepatobiliary and Pancreatic Diseases International. 2008 ; Vol. 7, No. 2. pp. 192-195.
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