Aisen Alex M, Sherman Stuart, Jennings S Gregory, Fogel Evan L, Li Tao, Cheng Chi-Liang, Devereaux Benedict M, McHenry Lee, Watkins James L, Lehman Glen A
Department of Radiology, Indiana University School of Medicine, 550 N. University Blvd, Room 0279, Indianapolis, IN, 46202, USA.
Acad Radiol. 2008 May;15(5):601-9. doi: 10.1016/j.acra.2007.12.009.
To measure main pancreatic duct diameter (PDD) with magnetic resonance pancreatography (MRP) before and after secretin injection in patients with suspected sphincter of Oddi dysfunction (SOD) and to determine if the diameter change is predictive of sphincter of Oddi manometry (SOM) results.
We identified all patients during the study period referred for SOM for clinically suspected SOD; patients with an intact sphincter and without contraindication to MRP examination were considered for study entry. Consenting patients underwent MRP, including dynamic imaging of the pancreatic duct after intravenous administration of porcine secretin followed by SOM during endoscopic retrograde cholangiopancreatography. MRP was defined as abnormal when PDD remained increased by > or = 1.0 mm from baseline 15 minutes after secretin injection. SOM was abnormal when basal sphincter pressure (SP) was > or = 40 mm Hg. Mean PDD before and after secretin administration was compared within normal and abnormal SP groups with two-tailed unpaired t-test; the mean difference between baseline and peak PDD and duration of > or = 0.5 mm increase in PDD was compared between groups with two-tailed t-test. P < .05 was considered significant.
Of 70 patients referred for SOM, 30 met all entry criteria, gave consent to participate, and underwent both MRP and SOM. Ten of 30 patients (33%) had normal SP; 20 (67%) were abnormal. PDD increased significantly after secretin injection (normal SP, 1.62 +/- 0.73 to 2.78 +/- 0.77 mm, P < .01; abnormal SP, 1.45 +/- 0.26 to 2.32 +/- 0.75 mm, P < .01). There was no difference between normal and abnormal SP groups in amount of PDD increase (1.15 +/- 0.75 vs. 0.88 +/- 0.72 mm; P = .33) or duration of > or = 0.5 mm increase in PDD (5.28 +/- 8.76 vs. 13.60 +/- 13.00 minutes; P = 0.07).
In patients with suspected sphincter of Oddi dysfunction, magnetic resonance pancreatography demonstrated PDD increase following secretin injection but did not predict the results of manometry.
在疑似Oddi括约肌功能障碍（SOD）的患者中，通过磁共振胰胆管造影（MRP）测量注射促胰液素前后的主胰管直径（PDD），并确定直径变化是否可预测Oddi括约肌测压（SOM）结果。
我们确定了研究期间所有因临床疑似SOD而接受SOM检查的患者；括约肌完整且无MRP检查禁忌证的患者被纳入研究。同意参与的患者接受MRP检查，包括静脉注射猪促胰液素后对胰管进行动态成像，随后在内镜逆行胰胆管造影期间进行SOM检查。当促胰液素注射后15分钟PDD较基线水平仍增加≥1.0 mm时，MRP被定义为异常。当基础括约肌压力（SP）≥40 mmHg时，SOM被定义为异常。在正常和异常SP组中，使用双尾非配对t检验比较促胰液素给药前后的平均PDD；使用双尾t检验比较两组基线与PDD峰值之间的平均差异以及PDD增加≥0.5 mm的持续时间。P < 0.05被认为具有统计学意义。
在70例接受SOM检查的患者中，30例符合所有纳入标准，同意参与并接受了MRP和SOM检查。30例患者中有10例（33%）SP正常；20例（67%）异常。促胰液素注射后PDD显著增加（SP正常组，从1.62±0.73 mm增至2.78±0.77 mm，P < 0.01；SP异常组，从1.45±0.26 mm增至2.32±0.75 mm，P < 0.01）。SP正常和异常组之间PDD增加量（1.15±0.75 vs. 0.88±0.72 mm；P = 0.33）或PDD增加≥0.5 mm的持续时间（5.28±8.76 vs. 13.60±13.00分钟；P = 0.07）无差异。
在疑似Oddi括约肌功能障碍的患者中，磁共振胰胆管造影显示促胰液素注射后PDD增加，但无法预测测压结果。
