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

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15 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Sep 23 2016

Fingerprint

Chronic Pancreatitis
Pancreas
Secretin
Bicarbonates
Magnetic Resonance Cholangiopancreatography
Spleen
Pancreatic Juice
Sensitivity and Specificity
Area Under Curve
Fats

Keywords

  • Chronic pancreatitis
  • Dysfunction
  • Exocrine
  • Magnetic resonance imaging
  • Secretin stimulation test

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology
  • Radiological and Ultrasound Technology

Cite this

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title = "Detection of exocrine dysfunction by MRI in patients with early chronic pancreatitis",
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.",
keywords = "Chronic pancreatitis, Dysfunction, Exocrine, Magnetic resonance imaging, Secretin stimulation test",
author = "Temel Tirkes and Evan Fogel and Stuart Sherman and Chen Lin and Jordan Swensson and M. Akisik and Kumar Sandrasegaran",
year = "2016",
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language = "English (US)",
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TY - JOUR

T1 - Detection of exocrine dysfunction by MRI in patients with early chronic pancreatitis

AU - Tirkes, Temel

AU - Fogel, Evan

AU - Sherman, Stuart

AU - Lin, Chen

AU - Swensson, Jordan

AU - Akisik, M.

AU - Sandrasegaran, Kumar

PY - 2016/9/23

Y1 - 2016/9/23

N2 - 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.

AB - 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.

KW - Chronic pancreatitis

KW - Dysfunction

KW - Exocrine

KW - Magnetic resonance imaging

KW - Secretin stimulation test

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