Suspected chronic pancreatitis with normal MRCP: Findings on MRI in correlation with secretin MRCP
Suspected chronic pancreatitis with normal MRCP: Findings on MRI in correlation with secretin MRCP
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DOI：
10.1002/jmri.21241
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发表时间：
2008-01-01
影响因子：
4.4
通讯作者：
Burton, Frank R.
中科院分区：
文献类型：
--
作者：
Balci, N. Cern;Alkaade, Samer;Burton, Frank R.
目的：为探讨胰泌素刺激的磁共振胰胆管成像（S-MRCP）对临床疑诊慢性胰腺炎、基础MRCP检查正常的胰腺MRI表现及其与胰腺外分泌功能的关系，材料与方法：对26例MRCP检查显示胰管直径正常、无侧分支扩张的患者进行MRI检查。一名放射科医生在一次会议上评估胰腺大小、胰腺信号强度比（SIR）和胰腺头部、体部和尾部的T-1加权脂肪抑制和连续对比增强图像上的动脉增强比（A/V）。采用综合评分对合并结果进行分级。序列S-MRCP与标准MRI在同一时段进行。结果：MRI正常7例，异常19例。DF程度分别与胰腺大小（r = 0.748）、SIR（r = 0.610）、A/V（r = 0.466）、综合评分（r = 0.833）和PDC（r = 0.554）的均值呈显著相关。PDC与SIR（r = 0.413）和综合评分（r = 0.452）相关，但与A/V和胰腺大小无关。在正常和异常DF分级之间，相关大小发现的平均值存在显著差异（P = 0.001），SIR（P = 0.008），A/V（P = 0.019），PDC（P = 0.001）。临床疑似慢性胰腺炎且MRCP表现正常的患者可能有一系列MRI表现，这些表现与估计的胰腺炎相关。外分泌功能不全的S-MRCP与越来越多的联合表现。
Purpose: To review pancreatic MRI findings and their relationship with estimated pancreatic exocrine function on secretin-stimulated MR cholangiopancreatography (S-MRCP) in patients with clinically suspected chronic pancreatitis and normal baseline MRCP findings.Materials and Methods: MRI findings of 26 patients with normal pancreatic duct diameter and without side branch ectasia on MRCP were evaluated. A single radiologist assessed pancreatic size, pancreatic signal intensity ratio (SIR), and arterial enhancement ratio (A/V) at head, body, and tail of the pancreas on T-1-weighted fat-suppressed and serial contrast-enhanced images at a single session. Combined findings were graded with a composite score. Serial S-MRCP was performed at the same session with standard MRI. Correlation and differences between MRI findings and associated grade of duodenal filling (I)F) or the degree of pancreatic duct caliber change (PDC) were analyzed.Results: Seven patients revealed normal and 19 patients abnormal MRI findings. Significant correlation was present between the degree of DF and mean values of pancreatic size (r = 0.748), SIR (r = 0,610), A/V (r = 0.466), composite score (r = 0.833), and PDC (r = 0.554) separately. PDC correlated with SIR (r = 0.413) and composite score (r = 0.452), but not with A/V or pancreatic size. Significant differences were present between normal and abnormal DF grades in terms of mean values of associated findings of size (P = 0.001), SIR (P = 0.008), A/V (P = 0.019), and PDC (P = 0.001).Conclusion: Patients with clinically suspected chronic pancreatitis and normal MRCP findings may have a spectrum of MRI findings that correlate with the estimated pancreatic exocrine insufficiency on S-MRCP with the increasing number of combined findings.