TY - JOUR
T1 - Jejunal response to secretin is independent of the pancreatic response in secretin-enhanced magnetic resonance cholangiopancreatography
AU - Hafezi-Nejad, Nima
AU - Singh, Vikesh K.
AU - Faghih, Mahya
AU - Kamel, Ihab
AU - Zaheer, Atif
PY - 2019/3
Y1 - 2019/3
N2 - 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.
AB - 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.
KW - Chronic pancreatitis
KW - Exocrine pancreatic insufficiency
KW - Magnetic resonance cholangiopancreatography
KW - Secretin
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U2 - 10.1016/j.ejrad.2018.12.024
DO - 10.1016/j.ejrad.2018.12.024
M3 - Article
C2 - 30777222
AN - SCOPUS:85059637691
SN - 0720-048X
VL - 112
SP - 7
EP - 13
JO - European Journal of Radiology
JF - European Journal of Radiology
ER -