Evaluation of pancreatic exocrine insufficiency by cine-dynamic MRCP using spatially selective inversion-recovery (IR) pulse: Correlation with severity of chronic pancreatitis based on morphological changes of pancreatic duct.

PURPOSE: To evaluate the correlation between the pancreatic exocrine insufficiency estimated by cine-dynamic MRCP using spatially selective IR pulse and the severity stages (modified Cambridge classification) based on morphological changes of the pancreatic duct in patients with suspected chronic pancreatitis.

MATERIALS AND

METHODS

Thirty-nine patients with suspected chronic pancreatitis underwent cine-dynamic MRCP with a spatially selective IR pulse. The secretion grading score (5-point scale) based on the moving distance of pancreatic juice inflow on cine-dynamic MRCP was assessed, and compared with the stage of the severity of chronic pancreatitis based on morphological changes of pancreatic duct.

RESULT: The stage of the severity of chronic pancreatitis based on morphological changes had significant negative correlations with the secretion grade (r=-0.698, P<0.001). The secretion grading score of stage 4 was significantly lower than stage 1-3 (P<0.001, P=0.002, P=0.025, respectively). In all 19 patients in stage 4, the secretion grading score was <0.70. The secretion grading score of stage 1 was significantly higher than stage 2 and 4 (P=0.019, P<0.001, respectively). In stage 2, the secretion grading score was <0.70 in 8 (89%) of 9 patients showing pancreatic exocrine insufficiency. Conversely, in stage 3, the secretion grading score was >0.70 in 2 (33%) of 6 patients showing normal pancreatic exocrine function.

CONCLUSION

It should be noted that the degree of morphological changes of pancreatic duct does not necessarily reflect the severity of pancreatic exocrine insufficiency at cine-dynamic MRCP in stage 2-3 chronic pancreatitis.