Secretin-Enhanced MRCP: How and Why-AJR Expert Panel Narrative Review.
Secretin-Enhanced MRCP: How and Why-AJR Expert Panel Narrative Review.
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Secralin增强的MRCP：如何以及为什么AJR专家小组叙事评论。
DOI：
10.2214/ajr.20.24857
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Tirkes T
中科院分区：
文献类型：
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作者：
Swensson J;Zaheer A;Conwell D;Sandrasegaran K;Manfredi R;Tirkes T
与标准MRCP相比，促胰液素增强的MRCP(S-MRCP)对胰胆管系统的成像具有多方面的优势。通过使用促胰液素诱导胰腺产生液体，并利用对液体敏感的MRCP序列，S-MRCP增加了对导管解剖的可视化，并提供了对胰腺功能的洞察，使放射科医生能够为一系列与胰腺相关的疾病提供更多的洞察力。这篇叙述性的综述提供了S-MRCP的实际实施的详细信息，包括患者准备、分泌素管理的后勤以及动态分泌素增强的MRCP获取。考虑到放射科医生对S-MRCP检查的解释和报告，包括评估主胰管和十二指肠液量的动态顺应性。本文综述了S-MRCP的主要适应证，包括胰腺分裂、胰胆管连接部异常、肝内胆管膨出、慢性胰腺炎、主胰管狭窄等，以及术后复杂解剖的评估。本文还介绍了不明确或有争议的适应症，以及作者对这些适应症的处理方法；这些适应症包括急性或复发性急性胰腺炎、胰腺外分泌功能、Oddi括约肌功能障碍和胰腺肿瘤。
Secretin-enhanced MRCP (S-MRCP) provides multiple advantages compared with standard MRCP for imaging the pancreaticobiliary tree. By using secretin to induce fluid production from the pancreas, and leveraging fluid-sensitive MRCP sequences, S-MRCP increases visualization of ductal anatomy and provides insight into pancreatic function, allowing radiologists to offer additional insight for a range of pancreatic-related conditions. This narrative review provides detailed information on the practical implementation of S-MRCP, including patient preparation, logistics of secretin administration, and dynamic secretin-enhanced MRCP acquisition. Considerations are given for radiologists’ interpretation and reporting of S-MRCP examinations, including assessment of dynamic compliance of the main pancreatic duct and of duodenal fluid volume. Established indications for S-MRCP are reviewed, including pancreas divisum, anomalous pancreaticobiliary junction, Santorinicele, Wirsungocele, chronic pancreatitis, main pancreatic duct stenosis, and assessment of complex postoperative anatomy. Equivocal or controversial indications are also presented, along with the authors’ approach to such indications; these include acute or recurrent acute pancreatitis, pancreatic exocrine function, sphincter of Oddi dysfunction, and pancreatic neoplasms.