Published in:
01-03-2017
Secretin-stimulated MRI assessment of exocrine pancreatic function in patients with cystic fibrosis and healthy controls
Authors:
Adnan Madzak, Trond Engjom, Gaute K. Wathle, Søren Schou Olesen, Erling Tjora, Pål R. Njølstad, Birger Norderud Lærum, Asbjørn Mohr Drewes, Georg Dimcevski, Jens Brøndum Frøkjær, Ingfrid S. Haldorsen
Published in:
Abdominal Radiology
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Issue 3/2017
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Abstract
Purpose
Secretin-stimulated magnetic resonance imaging (s-MRI) and pancreatic diffusion weighted imaging (DWI) are novel non-invasive imaging techniques for assessment of exocrine pancreatic insufficiency (EPI). The aim was to validate s-MRI assessed pancreatic secreted volume using novel semi-automatic quantification software, and to assess the ability of s-MRI with DWI to diagnose EPI in patients with cystic fibrosis (CF).
Methods
s-MRI and DWI was performed in 19 patients with CF (median age 21 years; range 16–56; eight men) and in 10 healthy controls (HC) (median age 46 years; range 20–65; four men). Sequential coronal T2-weighted images covering the duodenum and small bowel and axial DWI were acquired before and 1, 5, 9, and 13 min after secretin stimulation. A short endoscopic secretin test was used as reference method for EPI.
Results
CF patients with EPI had lower apparent diffusion coefficient before secretin in the pancreatic head (P < 0.001) and lower secreted bowel fluid volumes (P = 0.035) compared to HC and CF patients without EPI. ROC curve analyses identified that secreted fluid volume after 13 min yielded the highest diagnostic accuracy for diagnosing EPI (AUC 0.93; 95% CI [0.80–1.00]).
Conclusion
Pancreatic s-MRI is useful for the assessment of exocrine pancreatic function with high diagnostic accuracy for the diagnosis of EPI in CF.