Assessment of pancreatic volumes and secretory function by magnetic resonance cholangiopancreatography (MRCP) in children with suspected exocrine pancreatic insufficiency.

AIM: Exocrine pancreatic insufficiency (EPI) can be assessed noninvasively using magnetic resonance cholangiopancreatography (MRCP) with secretin stimulation. This pilot study measured pancreatic volumes in children with suspected EPI and quantified total secreted fluid volume after secretin stimulation.

MATERIALS AND

METHODS

We retrospectively reviewed MRCPs performed between 2011 and 2021. Pancreatic volume was quantified using parametric magnetic resonance imaging (MRI) software on axial T2-weighted images. Secreted volume after secretin administration was measured with regions of interest on coronal single-shot fast spin echo (SSFSE) thick-slab sequences including thresholded pixels in the stomach and small intestine.

RESULTS

We included 44 scans from 39 patients (23 males) in the study with a mean patient age of 10.7 ± 5.1 years. Median pancreas volume was 27.43 mL (interquartile range [IQR]: 15.92-53.51 mL). Pancreas volume correlated significantly with patient weight (Spearman's ρ = 0.63; P<0.001), height (ρ = 0.63; P<0.001), and body surface area (BSA) (ρ = 0.64; P<0.001). Median total secreted fluid volume after secretin was 71.35 mL (IQR: 31.77-119.56 mL). There was no statistically significant correlation of total secreted volume with patient age, weight, weight percentile, height percentile, body mass index (BMI), BMI percentile, or BSA (P>0.05).

CONCLUSION

We report MRCP-derived pancreas volumes and total secreted fluid volumes in a cohort of children undergoing clinically indicated MRCP. Our study demonstrates the feasibility of obtaining such measures using MRI as a noninvasive tool. Pancreas volume correlated strongly with body size (weight, height, and BSA) and moderately with patient age, height percentile, and BMI. In contrast, total secreted volume showed no correlation with demographic or anthropometric measures.