Khalid Asif, Peterson Mark, Slivka Adam
Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Dig Dis Sci. 2003 Aug;48(8):1475-81. doi: 10.1023/a:1024747319606.
Magnetic resonance pancreatography is a new modality to visualize the pancreatic duct. Prolonged dilation of the pancreatic duct following secretin administration may suggest obstruction at the level of the pancreatic duct orifice. We describe 10 patients with idiopathic acute recurrent pancreatitis who underwent secretin-stimulated magnetic resonance pancreatography with subsequent endoscopic retrograde pancreatogram with or without manometry. All patients had complete visualization of the main pancreatic duct and no evidence of chronic duct disease. Two patients had pancreas divisum. Three had prolonged dilation of the pancreatic duct on secretin-stimulated magnetic resonance pancreatography and evidence of pancreatic duct outflow obstruction. Four additional patients with pancreatic duct outflow obstruction had normal secretin-stimulated magnetic resonance pancreatography. In conclusion, secretin stimulated magnetic resonance pancreatography provides high quality pancreatic duct images and has high specificity but low sensitivity for diagnosing pancreatic duct outflow obstruction using manometric/clinical criteria.
磁共振胰胆管造影是一种用于显示胰管的新方法。注射促胰液素后胰管持续扩张可能提示胰管开口处存在梗阻。我们描述了10例特发性急性复发性胰腺炎患者，他们接受了促胰液素刺激的磁共振胰胆管造影，随后进行了内镜逆行胰胆管造影，部分患者还进行了测压。所有患者的主胰管均清晰显示，且无慢性胰管疾病的证据。2例患者存在胰腺分裂症。3例患者在促胰液素刺激的磁共振胰胆管造影中出现胰管持续扩张，并伴有胰管流出道梗阻的证据。另外4例胰管流出道梗阻患者的促胰液素刺激磁共振胰胆管造影结果正常。总之，促胰液素刺激的磁共振胰胆管造影可提供高质量的胰管图像，对于使用测压/临床标准诊断胰管流出道梗阻具有高特异性但低敏感性。
