Boraschi Piero, Donati Francescamaria, Gigoni Roberto, Odoguardi Francesco, Neri Emanuele, Boggi Ugo, Falaschi Fabio, Bartolozzi Carlo
2nd Department of Radiology, Pisa University Hospital, Via Paradisa 2, 56124 Pisa, Italy.
Abdom Imaging. 2007 Mar-Apr;32(2):207-14. doi: 10.1007/s00261-007-9178-4.
Our study was aimed to evaluate the functional status of pancreatic transplants using dynamic MR pancreatography after secretin stimulation.
Thirteen asymptomatic patients previously submitted to isolated pancreas (n = 6) or combined kidney-pancreas (n = 7) transplantation, with enteric-portal pancreatic drainage, underwent MR examination at 1.5 T using a phased-array coil. After the acquisition of axial and coronal T1- and T2-weighted sequences, dynamic MR pancreatography was performed using a coronal breath-hold, thick-slab (40-60 mm), single-shot T2-weighted fast spin-echo sequence. After the intravenous administration of secretin (Secrelux, Sanochemia; 1 cU/kg body/weight), a single-slice image acquisition was repeated every 30 s up to 15 min. We estimated the calibre changes of the pancreatic ductal system and the filling of the donor's duodenum on the basis of pancreatic secretion after secretin stimulation, also evaluated by using a mean signal intensity/time histogram in a chosen region of interest including the transplanted pancreas and the connected small bowel.
All patients well tolerated the examination, and no side effects were reported after secretin administration. In 12/13 cases, a significant increase (more than 1 mm) in the diameter of the mean pancreatic duct was observed after secretin stimulation; in all patients, a noticeable filling of the duodenal graft was demonstrated during dynamic MR pancreatography on both qualitative and quantitative analyses.
Dynamic MR imaging after secretin administration allows non-invasive evaluation of exocrine function of the pancreatic transplants and could be used to differentiate patients with graft rejection from those with normal graft function.
我们的研究旨在通过胰泌素刺激后的动态磁共振胰胆管造影评估胰腺移植的功能状态。
13例曾接受孤立胰腺移植（n = 6）或肾胰联合移植（n = 7）且采用肠门静脉胰腺引流的无症状患者，使用相控阵线圈在1.5 T下行磁共振检查。在采集轴位和冠状位T1加权及T2加权序列后，采用冠状位屏气、厚层（40 - 60 mm）、单次激发T2加权快速自旋回波序列进行动态磁共振胰胆管造影。静脉注射胰泌素（Secrelux，Sanochemia；1 cU/kg体重）后，每30秒重复采集单层面图像，持续15分钟。我们根据胰泌素刺激后的胰腺分泌情况，通过在包括移植胰腺和相连小肠的选定感兴趣区域使用平均信号强度/时间直方图，评估胰管系统的管径变化以及供体十二指肠的充盈情况。
所有患者对检查耐受性良好，注射胰泌素后未报告副作用。12/13例患者在胰泌素刺激后观察到平均胰管直径显著增加（超过1 mm）；在所有患者中，动态磁共振胰胆管造影的定性和定量分析均显示十二指肠移植物有明显充盈。
注射胰泌素后的动态磁共振成像可对胰腺移植的外分泌功能进行无创评估，并可用于区分移植排斥患者和移植功能正常的患者。
