Prospective Evaluation of Subjects With Chronic Asymptomatic Pancreatic Hyperenzymemia

Amodio, Antonio; Manfredi, Riccardo; Katsotourchi, A.; Gabbrielli, Armando; Benini, Luigi; Mucelli, Roberto Pozzi; Vantini, Italo; Frulloni, Luca

doi:10.1038/ajg.2012.125

Cited by 35 publications

(13 citation statements)

References 21 publications

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“…This difference should be explained, at least in part, by the modality of the enrollment. In fact, the subjects in our study were recruited at the community hospital [4] whereas, in the study of Amodio et al [6], the subjects with CNPH were referred to a tertiary center; thus, in the latter study, the incidence was probably enriched.…”

Section: Epidemiologymentioning

confidence: 86%

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Familial Pancreatic Hyperenzymemia

Pezzilli¹

2013

Pancreat Disorders Ther

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Section: Epidemiologymentioning

confidence: 86%

“…The exact incidence of asymptomatic chronic pancreatic hyperenzymemia is not known nor is that of CNPH. Within the group of patients having CNPH, familial pancreatic hyperenzymemia ranges from 4 [4] to 19.5% of cases [6]. This difference should be explained, at least in part, by the modality of the enrollment.…”

Section: Epidemiologymentioning

confidence: 96%

Familial Pancreatic Hyperenzymemia

Pezzilli¹

2013

Pancreat Disorders Ther

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“…Imaging with multidetector CT (59%), MRCP (67%) and EUS (21%) of 75 patients with suspected BPH at a mean of 14.7 months after initial detection of elevated pancreatic enzymes revealed pancreatic or extrapancreatic disease in 50.7% 16. Secretin-MRCP revealed alterations of the pancreatic duct in half of 160 subjects with a mean of 3.3 years after initial recognition of abnormal pancreatic enzymes 17. These changes were clinically relevant in 14.4% of patients.…”

Section: Discussionmentioning

confidence: 99%

Man with epigastric pain and persistently elevated serum lipase

Bachmeier¹,

Morton

2019

BMJ Case Rep

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Serum lipase and amylase are commonly requested in individuals presenting with abdominal pain for investigation of acute pancreatitis. Pancreatic hyperenzymaemia is not specific for acute pancreatitis, occurring in many other pancreatic and non-pancreatic conditions. Where persistent elevation of serum lipase and amylase occurs in the absence of a diagnosed cause or evidence of laboratory assay interference, ongoing radiological assessment for pancreatic disease is required for 24 months before a diagnosis of benign pancreatic hyperenzymaemia can be made. We report a case of a 71-year-old man with epigastric pain and elevated serum lipase levels. He was extensively investigated, but no pancreatic disease was detected. He is asymptomatic, but serum lipase levels remain elevated 18 months after his initial presentation.

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“…The measurement of the duodenal filling, index of the pancreatic exocrine reserve, may be performed both in a semiquantitative or quantitative manner (13,14,27,28). The limitation of secretin-enhanced MRCP in assessing most appropriate imaging technique for investigating subjects with chronic asymptomatic pancreatic hyperenzymemia (31). In these patients, MRPC imaging depicted a pancreatic disease in 27.5% cases; whereas secretin-enhanced MRCP depicted abnormal findings in 50% of the patients.…”

Section: Functionmentioning

confidence: 91%

Secretin-enhanced MR Imaging of the Pancreas

Manfredi¹,

Mucelli²

2016

Radiology

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1Secretin is a hormone that stimulates the exocrine pancreatic secretion of bicarbonate-rich fluid from the acinar cells of the pancreas that accumulates within the pancreatic ductal lumen. The exogenous administration of secretin improves the visualization of pancreatic ducts at magnetic resonance (MR) cholangiopancreatography (MRCP), because of an enlargement of the pancreatic duct system and an increase of the fluid content within the lumen of the pancreatic ducts, responsible of an increase of MR signal. In this review, the technique of secretin-enhanced MRCP, which has the aim to depict the whole pancreatic duct system, the biliary tree, the major and minor papillae, and the duodenum, will be described. Because of the anatomic contiguity between the pancreas and the gastrointestinal tract, the presence of fluid within the stomach may overlap with the pancreatic duct system and therefore the pancreatic duct may be difficult to visualize, representing a potential source of diagnostic pitfalls. The technique to reduce the signal intensity of the static fluid present within the stomach and in the duodenal lumen is also described. The technique of secretin administration will be illustrated, with emphasis on the synchronization of secretin administration and MR image acquisition. Furthermore, the frequency and number of MRCP images necessary to achieve a temporal resolution adequate to visualize the physiologic changes in the pancreatic gland, induced by the administration of secretin, is described. The assessment of pancreatic, morphologic, and functional response to the administration of secretin, as depicted on MRCP images, will be illustrated. Finally, the indications for secretin-enhanced MRCP will be discussed to define which patients will benefit from secretin-enhanced MR imaging for their treatment planning. © RSNA, 2016 This copy is for personal use only. To order printed copies, contact reprints@rsna.org I n recent years, magnetic resonance (MR) imaging has increased its role in the detection and characterization of pancreatic diseases. This is most likely due to the capability of MR imaging to simultaneously assess the pancreatic parenchyma and the pancreatic and bile duct systems. This can be achieved by obtaining cross-sectional MR images by using breath-hold T1-weighted gradient-echo sequences performed as two-or three-dimensional gradient-echo, fat-suppression techniques; T2-weighted half-Fourier pulse sequences; diffusion-weighted imaging; and dynamic contrast material-enhanced imaging following the administration of gadolinium chelates that are able to depict and characterize focal pancreatic masses and evaluate diffuse pancreatic diseases. Furthermore, MR cholangiopancreatography (MRCP) is STATE OF THE ART: Essentialsn Secretin-enhanced magnetic resonance cholangiopancreatography (MRCP) is indicated in patients with chronic asymptomatic hyperenzymemia, recurrent acute pancreatitis, sphincter of Oddi dysfunction, anatomic variants, chronic pancreatitis, and main pancreatic duct stenosis.n Se...

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Prospective Evaluation of Subjects With Chronic Asymptomatic Pancreatic Hyperenzymemia

Abstract: Alterations of the pancreatic duct system at s-MRCP in subjects with CAPH can be observed in 50% of the subjects and are clinically relevant in 14.4% of cases.

Cited by 35 publications

References 21 publications

Familial Pancreatic Hyperenzymemia

Familial Pancreatic Hyperenzymemia

Man with epigastric pain and persistently elevated serum lipase

Secretin-enhanced MR Imaging of the Pancreas

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