Manfredi R, Costamagna G, Brizi M G, Maresca G, Vecchioli A, Colagrande C, Marano P
Department of Radiology, A. Gemelli University Hospital, Rome, Italy.
Radiology. 2000 Mar;214(3):849-55. doi: 10.1148/radiology.214.3.r00mr24849.
To assess whether secretin stimulation improves visualization of the pancreatic ducts at magnetic resonance (MR) cholangiopancreatography (MRCP) in patients with severe chronic pancreatitis or suspected pancreatic disease.
Thirty-one patients (group 1) with chronic pancreatitis and 84 patients (group 2) with clinical and/or laboratory findings suggestive of pancreatic disease who did not have ductal alterations at ultrasonography (US) and/or computed tomography (CT) underwent MRCP before and up to 10 minutes after secretin stimulation. Size of the main pancreatic duct (head, body, tail) and duodenal filling before and after secretin stimulation were measured quantitatively. Image quality, number of main pancreatic ductal segments visualized, visualization of side branches, ductal narrowing, endoluminal filling defects, and presence of pancreas divisum were analyzed qualitatively.
In both groups, the size of the main pancreatic duct increased significantly 3 minutes after secretin stimulation. Reduced duodenal filling was detected in patients with severe chronic pancreatitis (P < .001). The number of segments of the main pancreatic duct visualized improved from 85 (91%) to 93 (100%) of 93 in group 1 and from 164 (65%) to 245 (97%) of 252 (P < .001) in group 2. Visualization of side branches improved from 22 (71%) to 31 (100%) of 31 in group 1 and from three (4%) to 53 (63%) of 84 (P < .001) in group 2. Pancreas divisum was visualized in one additional patient in group 1 and in six additional patients in group 2.
The administration of secretin improves visualization of the pancreatic ducts and helps in the evaluation of exocrine reserve.
评估在患有严重慢性胰腺炎或疑似胰腺疾病的患者中，促胰液素刺激是否能改善磁共振胰胆管造影（MRCP）时胰腺导管的显影。
31例慢性胰腺炎患者（第1组）和84例临床及/或实验室检查结果提示胰腺疾病、超声（US）和/或计算机断层扫描（CT）未见导管改变的患者，在促胰液素刺激前及刺激后10分钟内行MRCP检查。定量测量促胰液素刺激前后主胰管（头部、体部、尾部）的大小及十二指肠充盈情况。对图像质量、主胰管显影节段数、分支显影情况、导管狭窄、腔内充盈缺损及胰腺分裂症的存在情况进行定性分析。
两组中，促胰液素刺激3分钟后主胰管大小均显著增加。重度慢性胰腺炎患者十二指肠充盈减少（P <.001）。第1组主胰管显影节段数从93个中的85个（91%）增至93个中的93个（100%），第2组从252个中的164个（65%）增至252个中的245个（97%）（P <.001）。第1组分支显影从31个中的22个（71%）增至31个中的31个（100%），第2组从84个中的3个（4%）增至84个中的53个（63%）（P <.001）。第1组额外有1例患者显影出胰腺分裂症，第2组额外有6例患者显影出胰腺分裂症。
促胰液素的应用可改善胰腺导管的显影，并有助于评估外分泌储备。
