European journal of radiology · 2009
Secretin-stimulated MR cholangio-pancreatography in the evaluation of asymptomatic patients with non-specific pancreatic hyperenzymemia.
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Donati Francescamaria, Boraschi Piero, Gigoni Roberto, Salemi Simonetta, Faggioni Lorenzo, Bertucci Cristina, Cecchi Claudia, Bartolozzi Carlo, Falaschi Fabio
Аннотация
PURPOSE: To assess the diagnostic value of secretin-stimulated MRCP (SS-MRCP) compared with conventional MRCP in asymptomatic patients with mild elevations of pancreatic enzymes.
MATERIALS AND METHODS: Eighty asymptomatic patients with pancreatic hyperenzymemia underwent MR imaging at 1.5T-device (Signa EXCITE, GE Healthcare). After the acquisition of axial T1w,T2w sequences, and conventional MRCP, SS-MRCP was performed using a single-slice coronal breath-hold, thick-slab, SSFSE T2w sequence, repeated every 30s up to 15 min following intravenous injection of secretin (Secrelux, Sanochemia).
RESULTS: On the basis of the standards of reference, our final diagnoses were: negative findings (n=23), pancreas divisum (n=22), mild chronic pancreatitis (n=14), inflammatory ampullary stenosis (n=3), juxtapapillary duodenal diverticulum (n=1), small cystic lesions (<1cm) (n=22; 5/22 cases associated with pancreas divisum). The image quality of SS-MRCP was significantly higher than that of conventional MRCP (p<0.0001). Standards of reference did not differ significantly from of SS-MRCP findings (p=0.5), while was statistically different from those of conventional MRCP (p<0.0001). A significant difference was found between conventional MRCP and SS-MRCP findings (p<0.0001).
CONCLUSION: In asymptomatic patients with non-specific pancreatic hyperenzymemia SS-MRCP may represent the best non-invasive diagnostic technique, since it gives morphological and functional information.
MATERIALS AND METHODS: Eighty asymptomatic patients with pancreatic hyperenzymemia underwent MR imaging at 1.5T-device (Signa EXCITE, GE Healthcare). After the acquisition of axial T1w,T2w sequences, and conventional MRCP, SS-MRCP was performed using a single-slice coronal breath-hold, thick-slab, SSFSE T2w sequence, repeated every 30s up to 15 min following intravenous injection of secretin (Secrelux, Sanochemia).
RESULTS: On the basis of the standards of reference, our final diagnoses were: negative findings (n=23), pancreas divisum (n=22), mild chronic pancreatitis (n=14), inflammatory ampullary stenosis (n=3), juxtapapillary duodenal diverticulum (n=1), small cystic lesions (<1cm) (n=22; 5/22 cases associated with pancreas divisum). The image quality of SS-MRCP was significantly higher than that of conventional MRCP (p<0.0001). Standards of reference did not differ significantly from of SS-MRCP findings (p=0.5), while was statistically different from those of conventional MRCP (p<0.0001). A significant difference was found between conventional MRCP and SS-MRCP findings (p<0.0001).
CONCLUSION: In asymptomatic patients with non-specific pancreatic hyperenzymemia SS-MRCP may represent the best non-invasive diagnostic technique, since it gives morphological and functional information.