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Detection of exocrine dysfunction by MRI in patients with early chronic pancreatitis

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Abstract

Purpose

To determine if T1-weighted MR signal of the pancreas can be used to detect early CP.

Methods

A retrospective analysis was performed on 51 suspected CP patients, who had both secretin-enhanced magnetic resonance cholangiopancreatography (S-MRCP) and an intraductal secretin stimulation test (IDST). There were 29 patients in normal and 22 patients in the low bicarbonate group. Bicarbonate level, total pancreatic juice volume, and excretory flow rate were recorded during IDST. Signal intensity ratio of pancreas (SIR), fat signal fraction, pancreatograms findings, and grade of duodenal filling were recorded on S-MRCP by two blinded radiologists.

Results

There was a significant difference in the signal intensity ratio of the pancreas to spleen (SIRp/s) between the normal and low bicarbonate groups (p < 0.0001). A significant positive correlation was found between pancreatic fluid bicarbonate level and SIRp/s (p < 0.0001). SIRp/s of 1.2 yielded sensitivity of 77% and specificity of 83% for detection of pancreatic exocrine dysfunction (AUC: 0.89).

Conclusion

T1-weighted MR signal of the pancreas has a high sensitivity and specificity for the detection of parenchymal abnormalities related to exocrine dysfunction and can therefore be helpful in evaluation of suspected early CP.

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Authors and Affiliations

  1. Department of Radiology and Clinical Sciences, Indiana University School of Medicine, 550 N. University Blvd. Suite 0663, Indianapolis, IN, 46202, USA

    Temel Tirkes, Chen Lin, Jordan Swensson, Fatih Akisik & Kumaresan Sandrasegaran

  2. Division of Gastroenterology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

    Evan L. Fogel & Stuart Sherman

Authors
  1. Temel Tirkes
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  2. Evan L. Fogel
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  3. Stuart Sherman
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Correspondence to Temel Tirkes.

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Authors do not have any relevant conflict of interest with this study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. T1

his article does not contain any studies with animals performed by any of the authors.

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Tirkes, T., Fogel, E.L., Sherman, S. et al. Detection of exocrine dysfunction by MRI in patients with early chronic pancreatitis. Abdom Radiol 42, 544–551 (2017). https://doi.org/10.1007/s00261-016-0917-2

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  • DOI: https://doi.org/10.1007/s00261-016-0917-2

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