Gillams, A.; Pereira, S.; Lees, W.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA18
Academic Journal
Introduction: We have previously reported the use of secretin MRCP to quantify pancreatic function. We have now studied a group of normal patients and patients with chronic pancreatitis. Methods: 62 patients referred with suspected or known pancreatic pathology underwent SSFSE MRCP both before and after O. 1 mi/kg IV secretin. The sequence with identical positioning and receiver gain was performed prior to secretin and at 2 min intervals post-secretin to a mean of 7 min. All patients also underwent parenchymal pancreatic imaging with a coronal trufisp and axial T1W sequence. The pancreatic flow rate was calculated as the change in signal intensity over time within a ROI that encompassed not only the pancreas but the small bowel. A voxel containing 100% water was used to correct for variations in receiver gain between individuals. 63 patients had concurrent CT scans. Using the Cambridge classification patients were divided into mild, moderate, and severe chronic pancreatitis. Results: There were 31 patients with a normal pancreas. The mean flow rate was 8.0 ml/min +/- 2.6. 31 patients had evidence of chronic pancreatitis, 6 mild, 6 moderate, and 19 severe chronic pancreatitis. The mean flow rates were; mild pancreatitis 6.9 +/- 1.7, moderate 6.0 +/- 1.7, and severe 5.9 +/- 2.9. This was statistically significant from the normal group. Conclusion: Significantly different flow rates were found in patients with severe chronic pancreatitis compared with normals. Further, there appeared to be trend down through the different levels of severity of chronic pancreatitis. Changes in flow rates in a given individual should provide useful information and a trend down on sequential measurements may prove to be an early indicator for pancreatic disease.


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