[Diagnostic value of secretin injections in dynamic MR pancreatography].

PURPOSE: To evaluate the effect of intravenous injections of secretin during MRP procedures.

MATERIAL AND METHODS: From 1998 to 2001, 340 patients were examined with MRP. Depending on the native MRI/MRP diagnosis, 110 of them received an injection of secretin followed by multiple MRP's (every 2 minutes) up to 10 min after injection. Diagnosis included healthy persons (n = 23), pancreas divisum (n = 11), chronic pancreatitis (n = 68), and pancreatic tumors (n = 22); some patients had more than 1 diagnosis. Visibility of duct structures and amount of fluid filling of the duodenum after secretin injection were evaluated (dynamic examination) based on a five-point scale. Differences were tested statistically by means of Mc Nemar's test and ROC analysis.

RESULTS: The visibility of the pancreatic duct could be increased significantly after secretin injection in all subgroups (p < 0.05). Statistically, it turned out not to be important at what time point after injection the MRP was taken. It was possible to evaluate the excretion rate of the pancreas. In healthy persons and those with pancreas divisum, the fluid filling of the duodenum was significantly higher than in those with chronic pancreatitis or pancreatic tumors. However, this finding alone did not suffice in differentiating between both groups (sensitivity 0.68 and specificity 0.59, respectively).

CONCLUSION: The i. v. injection of secretin improves the ability of MRP to evaluate the pancreas by increasing the visibility of the pancreatic duct structures and provides a method to assess the excretion rate of the gland.