Jejunal response to secretin is independent of the pancreatic response in secretin-enhanced magnetic resonance cholangiopancreatography

Nima Hafezi-Nejad, Vikesh K. Singh, Mahya Faghih, Ihab R. Kamel, Atif Zaheer

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To investigate whether jejunal secretions are independent of the pancreatic response to secretin in secretin-enhanced Magnetic Resonance Cholangiopancreatography (s-MRCP) examination of subjects with and without chronic pancreatitis (CP). Methods: Patients were identified through a search of s-MRCP examinations performed between 2014–2016 (n = 513) as well as the multidisciplinary pancreatitis clinic registry (n = 586). Fifty cases with CP (based on M-ANNHEIM criteria) and 50 matched controls were selected. Signal intensity changes after secretin administration (˜1–5 min’ post-secretin response) in three locations were assessed: second portion of the duodenum (D2), third/fourth portions of the duodenum (D3-4), and the jejunum. The post-secretin response was compared between (cases vs. controls) and within the study groups. Results: There was a significantly lower 1–5 min’ post-secretin response among CP patients in D2 (all p-values <0.01). However, no significant difference in 1–5 min’ post-secretin response was detected in the jejunum. Minute-by-minute analysis of the post-secretin response showed a significant increase up to the 5th minute only in D2 of the control group. The post-secretin response in the jejunum was significant after 1 min but was similar among patients with CP and controls. CP was a significant determinant of post-secretin response in D2 but not in the jejunum. Conclusions: Early post-secretin response at jejunum is independent of the pancreatic response that can be detected at D2, and should not be misinterpreted as a rapid pancreatic response. Therefore, pancreatic function on s-MRCP should be assessed by the presence of fluid in D2 and not jejunum.

Original languageEnglish (US)
Pages (from-to)7-13
Number of pages7
JournalEuropean Journal of Radiology
Volume112
DOIs
StatePublished - Mar 2019

Keywords

  • Chronic pancreatitis
  • Exocrine pancreatic insufficiency
  • Magnetic resonance cholangiopancreatography
  • Secretin

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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