Magnetic resonance hydrometry: non-invasive quantification of the exocrine pancreatic function

Abstract

Our study demonstrated the feasibility of measuring pancreatic output by MRH after stimulation with secretin. Moreover, a distinction between normal secretion and patients with chronic pancreatitis is possible.

Quantification of pancreatic exocrine function with secretin-enhanced magnetic resonance cholangiopancreatography: normal values and short-term effects of pancreatic duct drainage procedures in chronic pancreatitis. Initial results

“…Under secretin stimulation, the increase of the pancreatic exocrine volumes over time was linear for all subjects, followed by a plateau phase in 30% of the examinations in the control group, in 15% in patients with impaired pancreatic exocrine function and in 70% in patients with preserved pancreatic exocrine function. According to our results, the observation of a plateau phase at the end of the experiment does not correlate to a reduced secretory capacity of the exocrine pancreas [17]. Rather, it may correlate to the achievement of the maximal excretory capacity before the end of the acquisition.…”

“…Previous studies have suggested the great potential of S-MRCP in such an attempt [11,12,[15][16][17]. The present study has demonstrated that S-MRCP allows quantification of pancreatic exocrine secretions during secretin stimulation and, although these initials results were obtained in a limited number of patients, suggests that it Numbers correspond to patients in Table 1 Fig .…”

“…The pancreatic flow output (total excreted volume) was 7.1 ml/min (111 ml) before treatment and 8.6 ml/min (146 ml) after treatment could be of major usefulness for diagnosis and follow-up of acute and chronic pancreatitis. The method used here to quantify pancreatic exocrine secretions using S-MRCP is based on a linear relationship between signal intensity and fluid volume, as it has already been verified by previous published studies [15][16][17]. During the dynamic S-MRCP acquisitions, peristalsis and variable breath-hold levels may result in fluid repositioning that could lead to fluid loss out of the ROI.…”

“…Furthermore, the same ROI was used for both calibration and measurements, which rendered the whole procedure less operator-dependent and avoided the use of a specific reference ROI that would have been more affected by factors such as surface coil distance. The individual internal reference value and the choice of the same ROI for both calibration and measurements constitute the main differences between the present and previous studies as the latter were based either on the calculation of a common external reference value from a group of healthy volunteers [15,17] or on the choice of a separate ROI for the reference value containing 100% of water and located in the stomach [16]. A possible limitation of our calibration procedure is that it was performed 15 min after the administration of secretin.…”

“…Secretin-enhanced magnetic resonance (MR) cholangiopancreatography (S-MRCP) is a non-invasive imaging technique that allows the depiction of morphologic changes in pancreatic ducts and a qualitative assessment of exocrine function by monitoring duodenal filling after exocrine stimulation [11][12][13][14]. Furthermore, recent developments in S-MRCP techniques have shown the feasibility of a quantitative assessment of the pancreatic exocrine function [15][16][17]. These quantification methods have demonstrated a linear relationship between MR signal intensity and fluid volume, and both require a calibration procedure.…”