Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Department of Medicine, Haukeland University Hospital, 5021, Bergen, Norway.
Eur Radiol. 2018 Apr;28(4):1495-1503. doi: 10.1007/s00330-017-5115-2. Epub 2017 Nov 13.
Secretin-stimulated magnetic resonance imaging (s-MRI) is the best validated radiological modality assessing pancreatic secretion. The purpose of this study was to compare volume output measures from secretin-stimulated transabdominal ultrasonography (s-US) to s-MRI for the diagnosis of exocrine pancreatic failure in cystic fibrosis (CF).
We performed transabdominal ultrasonography and MRI before and at timed intervals during 15 minutes after secretin stimulation in 21 CF patients and 13 healthy controls. To clearly identify the subjects with reduced exocrine pancreatic function, we classified CF patients as pancreas-sufficient or -insufficient by secretin-stimulated endoscopic short test and faecal elastase.
Pancreas-insufficient CF patients had reduced pancreatic secretions compared to pancreas-sufficient subjects based on both imaging modalities (p < 0.001). Volume output estimates assessed by s-US correlated to that of s-MRI (r = 0.56-0.62; p < 0.001). Both s-US (AUC: 0.88) and s-MRI (AUC: 0.99) demonstrated good diagnostic accuracy for exocrine pancreatic failure.
Pancreatic volume-output estimated by s-US corresponds well to exocrine pancreatic function in CF patients and yields comparable results to that of s-MRI. s-US provides a simple and feasible tool in the assessment of pancreatic secretion.
• Cystic fibrosis patients with affected pancreas have reduced pancreatic secretions. • Secretin-stimulated sonography is a simple and feasible method to assess pancreatic output. • Secretin-simulated MRI is a more precise method to assess pancreatic secretions. • The sonographic and MRI methods yielded comparable pancreatic secretory output estimates.
促胰液素刺激磁共振成像（s-MRI）是评估胰腺分泌功能的最佳验证影像学方法。本研究旨在比较促胰液素刺激经腹超声（s-US）和 s-MRI 对囊性纤维化（CF）患者外分泌胰腺功能衰竭的诊断价值。
我们对 21 例 CF 患者和 13 例健康对照者进行了 s-US 和 MRI 检查，在促胰液素刺激前后以及刺激后 15 分钟内的不同时间点进行了检查。为了明确确定外分泌胰腺功能减退的患者，我们通过促胰液素刺激内镜短程试验和粪便弹性蛋白酶对 CF 患者进行了胰腺充足或不足的分类。
与胰腺充足的患者相比，胰腺不足的 CF 患者的胰腺分泌量减少，两种影像学方法均显示差异有统计学意义（p < 0.001）。s-US 评估的体积输出估计值与 s-MRI 相关（r = 0.56-0.62；p < 0.001）。s-US（AUC：0.88）和 s-MRI（AUC：0.99）均对外分泌胰腺功能衰竭具有良好的诊断准确性。
s-US 估计的胰腺体积输出与 CF 患者的外分泌胰腺功能密切相关，与 s-MRI 的结果相当。s-US 为评估胰腺分泌提供了一种简单可行的工具。
受影响的胰腺 CF 患者的胰腺分泌减少。
促胰液素刺激超声是评估胰腺输出的一种简单可行的方法。
促胰液素刺激 MRI 是评估胰腺分泌的更精确方法。
超声和 MRI 方法得出了可比的胰腺分泌输出估计值。
