Nanashima A, Yamaguchi H, Fukuda T, Sakamoto I, Kuroda A, Sawai T, Nakagoe T, Ayabe H
The First Department of Surgery, Nagasaki University School of Medicine, Nagasaki-shi, Japan.
J Gastroenterol Hepatol. 2001 Jan;16(1):87-92. doi: 10.1046/j.1440-1746.2001.02391.x.
To evaluate pancreatic exocrine function, we measured the changes in T2 enhanced hydrograhic intensity on magnetic resonance (MR) images of the pancreas following an injection of secretin, which is representative of the changes in duodenal fluid volume.
The subjects were 10 patients with normal pancreatic function (N > 70% detected by using a pancreatic function diagnostant test) and 12 patients with hypo-function, including those with mild hypo-function (MH, 50-70%, six patients) and severe hypo-function (SH < 50%, six patients).
In the N group, T2 enhanced intensity of the pancreas increased to a maximum value (more than 10% compared with baseline) within 5 min of stimulation, then gradually decreased. No significant difference in the response was observed between the head and body of the pancreas. Changes in the MH group were similar to those of the N group. In contrast, significantly lower changes in T2 enhanced intensity were observed in SH group, relative to both the N and MH group (P < 0.05). The amount of secretin-induced increase in duodenal fluid after 16 min was not significantly different among the three groups. Furthermore, an evaluation of the residual pancreatic tissue after a pancreatoduodenectomy was also feasible.
Our results indicate that the MR-secretin test is useful for the evaluation of severe pancreatic exocrine dysfunction. The diagnostic test is simple, direct and non-invasive.
为评估胰腺外分泌功能，我们在注射促胰液素后测量了胰腺磁共振（MR）图像上T2加权增强信号强度的变化，促胰液素可代表十二指肠液量的变化。
研究对象包括10例胰腺功能正常的患者（通过胰腺功能诊断试验检测，N>70%）和12例胰腺功能减退的患者，其中包括轻度胰腺功能减退（MH，50 - 70%，6例患者）和重度胰腺功能减退（SH<50%，6例患者）。
在N组中，胰腺的T2加权增强信号强度在刺激后5分钟内增加至最大值（与基线相比增加超过10%），然后逐渐下降。胰腺头部和体部的反应未观察到显著差异。MH组的变化与N组相似。相比之下，SH组的T2加权增强信号强度变化明显低于N组和MH组（P<0.05）。三组在16分钟后促胰液素诱导的十二指肠液增加量无显著差异。此外，对胰十二指肠切除术后残余胰腺组织的评估也是可行的。
我们的结果表明，MR-促胰液素试验对于评估严重胰腺外分泌功能障碍是有用的。该诊断试验简单、直接且无创。
