Cappeliez O, Delhaye M, Devière J, Le Moine O, Metens T, Nicaise N, Cremer M, Stryuven J, Matos C
Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, B-1070 Brussels, Belgium.
Radiology. 2000 May;215(2):358-64. doi: 10.1148/radiology.215.2.r00ma10358.
To compare duodenal filling seen at magnetic resonance (MR) pancreatography after secretin stimulation and biochemical parameters determined with the intraductal secretin test (IDST) for evaluation of pancreatic exocrine function.
MR pancreatography after secretin stimulation and IDST were performed in 41 patients with chronic pancreatitis (group 1) and eight patients with other pancreatic disease (group 2). A control group (group 3, n = 28) underwent MR pancreatography after secretin stimulation only. MR pancreatograms were acquired before and every 30 seconds for 10 minutes after secretin injection. Duodenal filling was graded from least amount of filling (grade 1) to normal filling (grade 3) on the last MR pancreatogram. Pancreatic exocrine function was determined at IDST. Main pancreatic ductal diameter was compared between groups 1 and 3.
All ductal diameters were significantly larger in group 1 (P <.001). The maximal diameter variation after secretin stimulation was significantly higher in the control group (P =.001). Pancreatic exocrine function parameters determined at IDST were significantly lower in patients with grade 1 duodenal filling than in those with grade 2 or 3 (P <.05). Maximal bicarbonate concentration alone was independently associated with all grades of duodenal filling (P =.007). The sensitivity and specificity of reduced duodenal filling for assessment of reduced pancreatic exocrine function were 72% and 87%, respectively.
Duodenal filling grade determined at MR pancreatography after secretin stimulation allows specific estimation of pancreatic exocrine function.
比较促胰液素刺激后磁共振胰胆管造影（MRP）所见十二指肠充盈情况与经导管促胰液素试验（IDST）测定的生化参数，以评估胰腺外分泌功能。
对41例慢性胰腺炎患者（第1组）和8例其他胰腺疾病患者（第2组）进行促胰液素刺激后的MRP及IDST。对照组（第3组，n = 28）仅接受促胰液素刺激后的MRP。在注射促胰液素前及注射后每30秒采集10分钟的MRP图像。根据最后一幅MRP图像上十二指肠充盈情况从最少充盈量（1级）到正常充盈（3级）进行分级。通过IDST测定胰腺外分泌功能。比较第1组和第3组的主胰管直径。
第1组所有导管直径均显著更大（P <.001）。促胰液素刺激后对照组的最大直径变化显著更高（P =.001）。IDST测定的胰腺外分泌功能参数在十二指肠充盈为1级的患者中显著低于2级或3级患者（P <.05）。仅最大碳酸氢盐浓度与所有十二指肠充盈等级独立相关（P =.007）。十二指肠充盈减少用于评估胰腺外分泌功能降低的敏感性和特异性分别为72%和87%。
促胰液素刺激后MRP测定的十二指肠充盈等级可对胰腺外分泌功能进行特异性评估。
