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Erschienen in: Abdominal Radiology 6/2007

01.11.2007

Evaluation of the stimulating effect of a low dose of secretin compared to the standard dose on the exocrine pancreas with MRCP: preliminary results in normal subjects (MRCP quantification of secretin stimulation)

verfasst von: Maria Antonietta Bali, Regis Sontou, Marianna Arvanitakis, Thierry Metens, Jacques Devière, Celso Matos

Erschienen in: Abdominal Radiology | Ausgabe 6/2007

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Abstract

Background

Secretin administration during MRCP improves depiction of pancreatic ducts and allows assessment of pancreatic exocrine secretions. However, secretin increases the cost of secretin-enhanced MRCP (S-MRCP). The aim of this study was to quantify using MRCP the stimulating effect of 0.3 CU/kg of secretin and to compare it to the standard dose (1 CU/kg).

Methods

Ten healthy volunteers underwent four S-MRCP (two for each dose). Pancreatic exocrine secretions were quantified by pancreatic flow output (PFO) and total excreted volume (TEV), derived from a linear regression between MR calculated pancreatic exocrine volumes and time. Two readers analysed individually all sets of images.

Results

A linear increase of pancreatic exocrine volumes was observed after administration of both doses of secretin. Intra-individual and inter-observer differences were not statistically significant (> 0.05). The mean PFO and TEV, given for reader 1 only, were, respectively, 6.9 ± 1.5 mL/min and 103 ± 26 mL for the standard dose and 6.1 ± 1.2 mL/min and 84 ± 19 mL for the dose of 0.3 CU/kg. Differences between PFO and TEV obtained with the two doses of secretin were statistically significant for both readers (P < 0.05).

Conclusions

MRCP is a non-invasive, reproducible tool that allows quantification of pancreatic exocrine secretions during secretin stimulation. PFO and TEV calculated with the low dose were still in the range of previously reported reference values. The administration of 0.3 CU/kg of secretin can reduce significantly the cost of S-MRCP.
Literatur
1.
Zurück zum Zitat Somogyi L, Ross SO, Cintron M, et al. (2003) Comparison of biologic porcine secretin, synthetic porcine secretin and synthetic human secretin in pancreatic function testing. Pancreas 27:230–234PubMedCrossRef Somogyi L, Ross SO, Cintron M, et al. (2003) Comparison of biologic porcine secretin, synthetic porcine secretin and synthetic human secretin in pancreatic function testing. Pancreas 27:230–234PubMedCrossRef
2.
Zurück zum Zitat Malfertheiner P, Büchler M, Stanescu A, et al. (1986) Exocrine pancreatic function in correlation to ductal and parenchymal morphology in chronic pancreatitis. Hepato-gastroenterol 33:110–114 Malfertheiner P, Büchler M, Stanescu A, et al. (1986) Exocrine pancreatic function in correlation to ductal and parenchymal morphology in chronic pancreatitis. Hepato-gastroenterol 33:110–114
3.
Zurück zum Zitat Ochi K, Harada H, Mizushima T, et al. (1997) Intraductal secretin test is as useful as duodenal secretin test in assessing exocrine pancreatic function. Dig Dis Sci 42:492–496PubMedCrossRef Ochi K, Harada H, Mizushima T, et al. (1997) Intraductal secretin test is as useful as duodenal secretin test in assessing exocrine pancreatic function. Dig Dis Sci 42:492–496PubMedCrossRef
4.
Zurück zum Zitat Robbrecht P, Cremer M, Vandermeers A, et al. (1975) Pancreatic secretions of total protein and three hydrolases collected in healthy subjects via duodenoscopic cannulation. Gastroenterology 69:374–379 Robbrecht P, Cremer M, Vandermeers A, et al. (1975) Pancreatic secretions of total protein and three hydrolases collected in healthy subjects via duodenoscopic cannulation. Gastroenterology 69:374–379
5.
Zurück zum Zitat Wada K, Yamadera K, Yokoyama K, et al. (1998) Application of pure pancreatic juice collection to the pancreatic exocrine function test. Pancreas 16:124–128PubMedCrossRef Wada K, Yamadera K, Yokoyama K, et al. (1998) Application of pure pancreatic juice collection to the pancreatic exocrine function test. Pancreas 16:124–128PubMedCrossRef
6.
Zurück zum Zitat Matos C, Metens T, Devière J, et al. (1997) Pancreatic duct: morphologic and functional evaluation with dynamic MR pancreatography after secretin stimulation. Radiology 203:435–441PubMed Matos C, Metens T, Devière J, et al. (1997) Pancreatic duct: morphologic and functional evaluation with dynamic MR pancreatography after secretin stimulation. Radiology 203:435–441PubMed
7.
Zurück zum Zitat Manfredi R, Costamagna G, Brizi MG, et al. (2000) Severe chronic pancreatitis versus suspected pancreatic disease: dynamic MR cholangiopancreatography after secretin stimulation. Radiology 214:849–855PubMed Manfredi R, Costamagna G, Brizi MG, et al. (2000) Severe chronic pancreatitis versus suspected pancreatic disease: dynamic MR cholangiopancreatography after secretin stimulation. Radiology 214:849–855PubMed
8.
Zurück zum Zitat Fukukura Y, Fujiyoshi F, Sasaki M, et al. (2002) Pancreatic duct: morphologic evaluation with MR cholangiopancreatography after secretin stimulation. Radiology 222:674–680PubMedCrossRef Fukukura Y, Fujiyoshi F, Sasaki M, et al. (2002) Pancreatic duct: morphologic evaluation with MR cholangiopancreatography after secretin stimulation. Radiology 222:674–680PubMedCrossRef
9.
Zurück zum Zitat Hellerhoff KJ, Helmberger H III, RöschT, et al. (2002) Dynamic MR pancreatography after secretin administration: image quality and diagnostic accuracy. AJR 179:121–129PubMed Hellerhoff KJ, Helmberger H III, RöschT, et al. (2002) Dynamic MR pancreatography after secretin administration: image quality and diagnostic accuracy. AJR 179:121–129PubMed
10.
Zurück zum Zitat Cappeliez O, Delhaye M, Devière J, et al. (2000) Chronic pancreatitis: evaluation of pancreatic exocrine function with MR pancreatography after secretin stimulation Radiology 215:358–364PubMed Cappeliez O, Delhaye M, Devière J, et al. (2000) Chronic pancreatitis: evaluation of pancreatic exocrine function with MR pancreatography after secretin stimulation Radiology 215:358–364PubMed
11.
Zurück zum Zitat Heverhagen JT, Müller D, Battmann A, et al. (2001) MR hydrometry to assess exocrine function of the pancreas: initial results of noninvasive quantification of secretion. Radiology 218:61–67PubMed Heverhagen JT, Müller D, Battmann A, et al. (2001) MR hydrometry to assess exocrine function of the pancreas: initial results of noninvasive quantification of secretion. Radiology 218:61–67PubMed
12.
Zurück zum Zitat Punwani S, Gillams AR, Lees WR (2003) Non-invasive quantification of pancreatic exocrine function using secretin-stimulated MRCP. Eur Radiol 13:273–276PubMed Punwani S, Gillams AR, Lees WR (2003) Non-invasive quantification of pancreatic exocrine function using secretin-stimulated MRCP. Eur Radiol 13:273–276PubMed
13.
Zurück zum Zitat Bali MA, Sztantics A, Metens T, et al. (2005) Quantification of pancreatic exocrine function with secretin-enhanced magnetic resonance cholangiopancreatography: normal values and short-term effects of pancreatic duct drainage procedures in chronic pancreatitis. Initial results. Eur Radiol 15:2110–2121PubMedCrossRef Bali MA, Sztantics A, Metens T, et al. (2005) Quantification of pancreatic exocrine function with secretin-enhanced magnetic resonance cholangiopancreatography: normal values and short-term effects of pancreatic duct drainage procedures in chronic pancreatitis. Initial results. Eur Radiol 15:2110–2121PubMedCrossRef
14.
Zurück zum Zitat Dreiling DA, Messer J (1978) The secretin story. Am J Gastroenterol 70:455–479PubMed Dreiling DA, Messer J (1978) The secretin story. Am J Gastroenterol 70:455–479PubMed
15.
Zurück zum Zitat Pruessmann KP, Weiger M, Scheidegger MB, et al. (1999) SENSE: sensitivity encoding for fast MRI. Magn Reson Med 42:952–962PubMedCrossRef Pruessmann KP, Weiger M, Scheidegger MB, et al. (1999) SENSE: sensitivity encoding for fast MRI. Magn Reson Med 42:952–962PubMedCrossRef
16.
Zurück zum Zitat Nicaise N, Pellet O, Metens T, et al. (1998) Magnetic resonance cholangiopancreatography: interest of IV secretin administration in the evaluation of pancreatic ducts. Eur Radiol 8:16–22PubMedCrossRef Nicaise N, Pellet O, Metens T, et al. (1998) Magnetic resonance cholangiopancreatography: interest of IV secretin administration in the evaluation of pancreatic ducts. Eur Radiol 8:16–22PubMedCrossRef
17.
Zurück zum Zitat Domschke S, Domschke W, Rösch W, et al. (1976) Bicarbonate and cyclic AMP content of pure human pancreatic juice in response to graded doses of synthetic secretin. Gastroenterology 70:533–536PubMed Domschke S, Domschke W, Rösch W, et al. (1976) Bicarbonate and cyclic AMP content of pure human pancreatic juice in response to graded doses of synthetic secretin. Gastroenterology 70:533–536PubMed
18.
Zurück zum Zitat Heverhagen JT, Battmann A, Kirsch M, et al. (2002) Magnetic resonance hydrometry: non-invasive quantification of the exocrine pancreatic function. Fortschr Röntgenstr 174:291–296CrossRef Heverhagen JT, Battmann A, Kirsch M, et al. (2002) Magnetic resonance hydrometry: non-invasive quantification of the exocrine pancreatic function. Fortschr Röntgenstr 174:291–296CrossRef
19.
Zurück zum Zitat Bozkurt T, Braun U, Leferink S, et al. (1994) Comparison of pancreatic morphology and exocrine functional impairment in patients with chronic pancreatitis. Gut 35:1132–1136PubMedCrossRef Bozkurt T, Braun U, Leferink S, et al. (1994) Comparison of pancreatic morphology and exocrine functional impairment in patients with chronic pancreatitis. Gut 35:1132–1136PubMedCrossRef
20.
Zurück zum Zitat Devière J, Gulbis B, Delhaye M, et al. (1985) Relation entre la morphologie canalaire et la fonction exocrine du pancréas: une méthode originale d’estimation linéaire de la fonction pancréatique. Acta Endoscopica 15:403–414CrossRef Devière J, Gulbis B, Delhaye M, et al. (1985) Relation entre la morphologie canalaire et la fonction exocrine du pancréas: une méthode originale d’estimation linéaire de la fonction pancréatique. Acta Endoscopica 15:403–414CrossRef
Metadaten
Titel
Evaluation of the stimulating effect of a low dose of secretin compared to the standard dose on the exocrine pancreas with MRCP: preliminary results in normal subjects (MRCP quantification of secretin stimulation)
verfasst von
Maria Antonietta Bali
Regis Sontou
Marianna Arvanitakis
Thierry Metens
Jacques Devière
Celso Matos
Publikationsdatum
01.11.2007
Verlag
Springer-Verlag
Erschienen in
Abdominal Radiology / Ausgabe 6/2007
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-006-9164-2

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