Imaging Institute, Cleveland Clinic, HB6, 9500 Euclid Ave, Cleveland, OH 44195, USA.
AJR Am J Roentgenol. 2012 Jan;198(1):124-32. doi: 10.2214/AJR.10.5713.
The purpose of this article is to present a proposal for quantification of exocrine function using secretin-enhanced MRCP for the diagnosis of chronic pancreatitis. The article also reviews the technique and application of secretin-enhanced MRCP in evaluating various pancreatic abnormalities.
One hundred thirty-four consecutive patients with chronic abdominal pain undergoing secretin-enhanced MRCP for suspected chronic pancreatitis were included. Patients were divided into four clinical groups (normal, equivocal, early chronic pancreatitis, established pancreatitis) on the basis of clinical symptoms and additional investigations, including CT (n=98), endoscopic pancreatic function test (n=65), endoscopic ultrasound (n=84), and ERCP (n=36). The volume of secretion was obtained by drawing a region of interest around T2 bright fluid secreted on postsecretin HASTE images. The maximal rate of secretion in response to secretin was obtained by plotting change in signal intensity on sequential postsecretin images. The analysis of variance test was used to compare the clinical groups with the volume and rate of secretion.
Significant volume differences were found between the normal and established pancreatitis groups (p<0.0001) as well as the equivocal and established pancreatitis groups (p<0.0005). Marginally significant differences were found between the normal and early pancreatitis groups (p=0.0150) as well as early and established pancreatitis groups (p=0.0351). Differences in the maximal rate of secretion were not statistically significant.
Secretory volume measurement of secretin-enhanced MRCP data is a simple method that brings out significant differences between normal, early, and established pancreatitis patients.
本文旨在提出一种使用促胰液素增强磁共振胰胆管成像（MRCP）量化外分泌功能的方法，用于诊断慢性胰腺炎。本文还回顾了促胰液素增强 MRCP 在评估各种胰腺异常方面的技术和应用。
对 134 例因疑似慢性胰腺炎而行促胰液素增强 MRCP 的慢性腹痛患者进行了回顾性研究。根据临床表现和其他检查（包括 CT [n=98]、内镜胰腺功能检查 [n=65]、内镜超声 [n=84]和 ERCP [n=36]），将患者分为四个临床组（正常、可疑、早期慢性胰腺炎、确诊胰腺炎）。通过在促胰液素后 HASTE 图像上绘制 T2 亮液分泌的感兴趣区来获得分泌量。通过绘制促胰液素后序列图像上信号强度的变化来获得最大分泌率。采用方差分析比较各组间的分泌量和分泌率。
正常组与确诊胰腺炎组（p<0.0001）以及可疑组与确诊胰腺炎组（p<0.0005）的分泌量差异有统计学意义。正常组与早期胰腺炎组（p=0.0150）以及早期组与确诊胰腺炎组（p=0.0351）的分泌量差异有统计学意义。最大分泌率的差异无统计学意义。
促胰液素增强 MRCP 数据的分泌量测量是一种简单的方法，可在正常、早期和确诊胰腺炎患者之间显示出显著差异。
