The Value of Secretin-Enhanced MRCP in Patients With Recurrent Acute Pancreatitis
dc.contributor.author | Sandrasegaran, Kumar | |
dc.contributor.author | Tahir, Bilal | |
dc.contributor.author | Barad, Udaykamal | |
dc.contributor.author | Fogel, Evan | |
dc.contributor.author | Akisik, Fatih | |
dc.contributor.author | Tirkes, Temel | |
dc.contributor.author | Sherman, Stuart | |
dc.contributor.department | Radiology and Imaging Sciences, School of Medicine | en_US |
dc.date.accessioned | 2018-03-02T21:05:18Z | |
dc.date.available | 2018-03-02T21:05:18Z | |
dc.date.issued | 2017-02 | |
dc.description.abstract | OBJECTIVE The purpose of this study is to assess the additional value of secretin-enhanced MRCP over conventional (non–secretin-enhanced) MRCP in diagnosing disease in patients with recurrent acute pancreatitis. MATERIALS AND METHODS A retrospective review of a radiology database found 72 patients with recurrent acute pancreatitis who had secretin-enhanced MRCP and ERCP correlation within 3 months of each other between January 2007 and December 2011. Of these patients, 54 had no history of pancreatic tumor or surgery and underwent MRI more than 3 months after an episode of acute pancreatitis. In addition, 57 age- and sex-matched control subjects with secretin-enhanced MRCP and ERCP correlation and without a diagnosis of recurrent acute pancreatitis or chronic pancreatitis were enrolled as the control group. All studies were anonymized, and secretin-enhanced MRCP images (image set A) were separated from conventional 2D and 3D MRCP and T2-weighted images (image set B). Image sets A and B for each patient were assigned different and randomized case numbers. Two blinded reviewers independently assessed both image sets for ductal abnormalities and group A image sets for exocrine response to secretin. RESULTS There were statistically significantly more patients with recurrent acute pancreatitis with reduced exocrine function compared with patients in the control group (32% vs 9%; p < 0.01) on secretin-enhanced images. Patients with recurrent acute pancreatitis were more likely to have side branch dilation (p = 0.02; odds ratio, 3.6), but not divisum, compared with the control group. Secretin-enhanced images were superior to non–secretin-enhanced images for detecting ductal abnormalities in patients with recurrent acute pancreatitis, with higher sensitivity (76% vs 56%; p = 0.01) and AUC values (0.983 vs 0.760; p < 0.01). CONCLUSION Up to one-third of patients with recurrent acute pancreatitis showed exocrine functional abnormalities. Secretin-enhanced MRCP had a significantly higher yield for ductal abnormalities than did conventional MRI and should be part of the MRCP protocol for investigation of patients with recurrent acute pancreatitis. | en_US |
dc.eprint.version | Author's manuscript | en_US |
dc.identifier.citation | Sandrasegaran, K., Tahir, B., Barad, U., Fogel, E., Akisik, F., Tirkes, T., & Sherman, S. (2017). The Value of Secretin-Enhanced MRCP in Patients With Recurrent Acute Pancreatitis. AJR. American Journal of Roentgenology, 208(2), 315–321. https://doi.org/10.2214/AJR.16.16566 | en_US |
dc.identifier.issn | 0361-803X | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/15346 | |
dc.language.iso | en_US | en_US |
dc.publisher | American Roentgen Ray Society(ARRS) | en_US |
dc.relation.isversionof | 10.2214/AJR.16.16566 | en_US |
dc.relation.journal | AJR. American journal of roentgenology | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | PMC | en_US |
dc.subject | MRCP | en_US |
dc.subject | pancreatitis | en_US |
dc.subject | secretin | en_US |
dc.title | The Value of Secretin-Enhanced MRCP in Patients With Recurrent Acute Pancreatitis | en_US |
dc.type | Article | en_US |