Division of Gastroenterology, Department of Internal Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile.
Department of Radiology, Hospital Clínico Universidad de Chile, Santiago, Chile.
Turk J Gastroenterol. 2022 Aug;33(8):704-709. doi: 10.5152/tjg.2022.21864.
To determine the effect of intramuscular administration of Neostigmine® on the visualization of the pancreatic duct on magnetic resonance cholangiopancreatography in patients with recurrent acute pancreatitis or abdominal pain.
We reviewed patients undergoing magnetic resonance cholangiopancreatography followed by a Neostigmine®-enhanced magnetic resonance cholangiopancreatography. Patients with a history of recurrent acute pancreatitis or abdominal pain who had a magnetic resonance cholangiopancreatography where the pancreatic duct was not entirely seen, were selected to undergo a second magnetic resonance cholangiopancreatography 40 minutes after 0.5 mg Neostigmine®. Images were analyzed by 2 radiologists. The diameter of the pancreatic duct was measured in the head, body, and tail of the pancreas on the baseline images and after Neostigmine®.
Ten patients were included, with a median age of 33 years (range 15-61). The maximum diameter of the pancreatic duct increased significantly after Neostigmine® administration in all patients, from 1.84 ± 0.98 to 3.41 ± 1.27 mm in the head, 1.34 ± 0.42 mm to 2.5 ± 0.49 mm in the body and 0.72 ± 0.52 mm to 1.78 ± 0.43 mm in the tail (mean ± SD, P < .0001). Neostigmine® helped to provide better detail of the pancreatic duct anatomy in 4 patients. In 2 patients we confirmed pancreas divisum, in another the Santorini duct was not seen on the baseline images but it was clearly visualized after Neostigmine®, and in the fourth patient, Neostigmine® improved visualization of multiple pancreatic duct stenosis.
Neostigmine®-magnetic resonance cholangiopancreatography significantly increases the diameter of the pancreatic duct, allowing an accurate morphological evaluation. It could be a cheap alternative to secretin, which is expensive and hardly available.
为了确定肌肉内注射新斯的明®对复发性急性胰腺炎或腹痛患者磁共振胰胆管成像中胰管显影的影响。
我们回顾了接受磁共振胰胆管成像后行新斯的明®增强磁共振胰胆管成像的患者。选择磁共振胰胆管成像显示胰管不完全显影的复发性急性胰腺炎或腹痛病史患者，在 0.5mg 新斯的明®后 40 分钟行第二次磁共振胰胆管成像。由 2 位放射科医生分析图像。在基线图像和新斯的明®后，测量胰头、胰体和胰尾的胰管直径。
纳入 10 例患者，中位年龄 33 岁（范围 15-61 岁）。所有患者新斯的明®给药后胰管最大直径均显著增加，胰头从 1.84±0.98 增至 3.41±1.27mm，胰体从 1.34±0.42mm 增至 2.5±0.49mm，胰尾从 0.72±0.52mm 增至 1.78±0.43mm（均数±标准差，P<.0001）。新斯的明®有助于 4 例患者更好地显示胰管解剖结构。在 2 例患者中我们证实了胰腺分裂，另 1 例患者的 Santorini 导管在基线图像上未显示，但在新斯的明®后清晰显示，在第 4 例患者中，新斯的明®改善了多发胰管狭窄的显示。
新斯的明®-磁共振胰胆管成像显著增加胰管直径，允许进行准确的形态学评估。它可能是昂贵且难以获得的促胰液素的廉价替代品。
