Comparison of Secretin-Stimulated Magnetic Resonance Pancreatography and Manometry Results in Patients with Suspected Sphincter of Oddi Dysfunction

Alex M. Aisen, Stuart Sherman, S. Gregory Jennings, Evan Fogel, Tao Li, Chi Liang Cheng, Benedict M. Devereaux, Lee McHenry, James L. Watkins, Glen Lehman

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Rationale and Objectives: 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. Materials and Methods: 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 ≥1.0 mm from baseline 15 minutes after secretin injection. SOM was abnormal when basal sphincter pressure (SP) was ≥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 ≥0.5 mm increase in PDD was compared between groups with two-tailed t-test. P < .05 was considered significant. Results: 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 ≥0.5 mm increase in PDD (5.28 ± 8.76 vs. 13.60 ± 13.00 minutes; P = 0.07). Conclusions: 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.

Original languageEnglish
Pages (from-to)601-609
Number of pages9
JournalAcademic Radiology
Volume15
Issue number5
DOIs
StatePublished - May 2008

Fingerprint

Sphincter of Oddi Dysfunction
Secretin
Pancreatic Ducts
Manometry
Sphincter of Oddi
Magnetic Resonance Spectroscopy
Pressure
Injections
Endoscopic Retrograde Cholangiopancreatography
Intravenous Administration
Swine

Keywords

  • ERCP
  • MRCP
  • secretin
  • sphincter of Oddi dysfunction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Comparison of Secretin-Stimulated Magnetic Resonance Pancreatography and Manometry Results in Patients with Suspected Sphincter of Oddi Dysfunction. / Aisen, Alex M.; Sherman, Stuart; Jennings, S. Gregory; Fogel, Evan; Li, Tao; Cheng, Chi Liang; Devereaux, Benedict M.; McHenry, Lee; Watkins, James L.; Lehman, Glen.

In: Academic Radiology, Vol. 15, No. 5, 05.2008, p. 601-609.

Research output: Contribution to journalArticle

Aisen, Alex M. ; Sherman, Stuart ; Jennings, S. Gregory ; Fogel, Evan ; Li, Tao ; Cheng, Chi Liang ; Devereaux, Benedict M. ; McHenry, Lee ; Watkins, James L. ; Lehman, Glen. / Comparison of Secretin-Stimulated Magnetic Resonance Pancreatography and Manometry Results in Patients with Suspected Sphincter of Oddi Dysfunction. In: Academic Radiology. 2008 ; Vol. 15, No. 5. pp. 601-609.
@article{7aae37b0ebbf404c9888adaacac5e25f,
title = "Comparison of Secretin-Stimulated Magnetic Resonance Pancreatography and Manometry Results in Patients with Suspected Sphincter of Oddi Dysfunction",
abstract = "Rationale and Objectives: 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. Materials and Methods: 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 ≥1.0 mm from baseline 15 minutes after secretin injection. SOM was abnormal when basal sphincter pressure (SP) was ≥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 ≥0.5 mm increase in PDD was compared between groups with two-tailed t-test. P < .05 was considered significant. Results: 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 ≥0.5 mm increase in PDD (5.28 ± 8.76 vs. 13.60 ± 13.00 minutes; P = 0.07). Conclusions: 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.",
keywords = "ERCP, MRCP, secretin, sphincter of Oddi dysfunction",
author = "Aisen, {Alex M.} and Stuart Sherman and Jennings, {S. Gregory} and Evan Fogel and Tao Li and Cheng, {Chi Liang} and Devereaux, {Benedict M.} and Lee McHenry and Watkins, {James L.} and Glen Lehman",
year = "2008",
month = "5",
doi = "10.1016/j.acra.2007.12.009",
language = "English",
volume = "15",
pages = "601--609",
journal = "Academic Radiology",
issn = "1076-6332",
publisher = "Elsevier USA",
number = "5",

}

TY - JOUR

T1 - Comparison of Secretin-Stimulated Magnetic Resonance Pancreatography and Manometry Results in Patients with Suspected Sphincter of Oddi Dysfunction

AU - Aisen, Alex M.

AU - Sherman, Stuart

AU - Jennings, S. Gregory

AU - Fogel, Evan

AU - Li, Tao

AU - Cheng, Chi Liang

AU - Devereaux, Benedict M.

AU - McHenry, Lee

AU - Watkins, James L.

AU - Lehman, Glen

PY - 2008/5

Y1 - 2008/5

N2 - Rationale and Objectives: 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. Materials and Methods: 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 ≥1.0 mm from baseline 15 minutes after secretin injection. SOM was abnormal when basal sphincter pressure (SP) was ≥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 ≥0.5 mm increase in PDD was compared between groups with two-tailed t-test. P < .05 was considered significant. Results: 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 ≥0.5 mm increase in PDD (5.28 ± 8.76 vs. 13.60 ± 13.00 minutes; P = 0.07). Conclusions: 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.

AB - Rationale and Objectives: 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. Materials and Methods: 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 ≥1.0 mm from baseline 15 minutes after secretin injection. SOM was abnormal when basal sphincter pressure (SP) was ≥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 ≥0.5 mm increase in PDD was compared between groups with two-tailed t-test. P < .05 was considered significant. Results: 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 ≥0.5 mm increase in PDD (5.28 ± 8.76 vs. 13.60 ± 13.00 minutes; P = 0.07). Conclusions: 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.

KW - ERCP

KW - MRCP

KW - secretin

KW - sphincter of Oddi dysfunction

UR - http://www.scopus.com/inward/record.url?scp=41949096696&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=41949096696&partnerID=8YFLogxK

U2 - 10.1016/j.acra.2007.12.009

DO - 10.1016/j.acra.2007.12.009

M3 - Article

C2 - 18423317

AN - SCOPUS:41949096696

VL - 15

SP - 601

EP - 609

JO - Academic Radiology

JF - Academic Radiology

SN - 1076-6332

IS - 5

ER -