Manfredi R, Costamagna G, Brizi M G, Spina S, Maresca G, Vecchioli A, Mutignani M, Marano P
Department of Radiology, A. Gemelli University Hospital, 8 Largo A. Gemelli, Rome, Italy.
Radiology. 2000 Nov;217(2):403-8. doi: 10.1148/radiology.217.2.r00nv29403.
To evaluate the usefulness of magnetic resonance (MR) cholangiopancreatography (MRCP) before and after secretin administration in diagnosing santorinicele in patients with pancreas divisum.
One hundred seven patients suspected of having pancreatic disease underwent MRCP before and after secretin administration (S-MRCP). S-MRCP images were evaluated for pancreas divisum and santorinicele and for size of the main pancreatic duct and santorinicele. The onset of duodenal filling was calculated on dynamic S-MRCP images.
Pancreas divisum was detected in five (5%) of 107 patients at MRCP and in 10 (9%) of 107 patients at S-MRCP. Santorinicele was detected in three (21%) of 14 patients at MRCP and in an additional four (seven [50%] of 14) patients at S-MRCP in patients with pancreas divisum. Santorinicele was confirmed in six of seven patients at endoscopic retrograde cholangiopancreatography (ERCP); in one of seven patients, ERCP was unsuccessful. The duct of Santorini was significantly (P: <.05) larger in the pancreatic head in patients with pancreas divisum and santorinicele (3.6 mm) compared with those with only pancreas divisum (2.2 mm). A noteworthy reduction in size of the pancreatic duct (26%) and of the santorinicele (63%) was observed after sphincterotomy. The onset of duodenal filling was delayed significantly in patients with santorinicele (2.1 vs 1.3 minutes; P: <.05).
S-MRCP helps in identifying pancreas divisum and santorinicele, which may be the cause of impeded pancreatic outflow.
评估在注射胰泌素前后进行磁共振胰胆管造影（MRCP）对诊断胰腺分裂症患者桑托里尼管囊肿的有效性。
107例疑似胰腺疾病的患者在注射胰泌素前后接受了MRCP检查（S-MRCP）。对S-MRCP图像进行评估，以确定胰腺分裂症和桑托里尼管囊肿情况，以及主胰管和桑托里尼管囊肿的大小。在动态S-MRCP图像上计算十二指肠充盈的起始时间。
在107例患者中，MRCP检查时发现5例（5%）存在胰腺分裂症，S-MRCP检查时发现10例（9%）。在胰腺分裂症患者中，MRCP检查时在14例患者中发现3例（21%）有桑托里尼管囊肿，S-MRCP检查时又额外发现4例（14例中的7例[50%]）有桑托里尼管囊肿。7例患者中6例在内镜逆行胰胆管造影（ERCP）时确诊为桑托里尼管囊肿；7例患者中有1例ERCP检查未成功。与仅患有胰腺分裂症的患者（2.2 mm）相比，患有胰腺分裂症和桑托里尼管囊肿的患者胰头处的桑托里尼管明显更大（3.6 mm，P <.05）。括约肌切开术后，观察到胰管大小显著减小（26%），桑托里尼管囊肿大小显著减小（63%）。有桑托里尼管囊肿的患者十二指肠充盈起始时间明显延迟（2.1分钟对1.3分钟；P <.05）。
S-MRCP有助于识别可能是胰腺流出受阻原因的胰腺分裂症和桑托里尼管囊肿。
