PANCREATIC DUCT - MORPHOLOGIC AND FUNCTIONAL-EVALUATION WITH DYNAMIC MR PANCREATOGRAPHY AFTER SECRETIN STIMULATION

PURPOSE: To assess the utility of dynamic MR pancreatography in the ev aluation of the behavior of the pancreatic duct after secretin stimula tion and to estimate pancreatic exocrine reserve in patients suspected of having acute recurrent or chronic pancreatitis. MATERIALS AND METH ODS: Ten healthy volunteers and 13 patients suspected of having pancre atic disease and no obvious markers of chronic pancreatitis were studi ed. Single-shot turbo spin-echo T2-weighted dynamic MR pancreatograms were obtained before and every 30 seconds during the 10 minutes after secretin administration. Morphologic features and diameter of the panc reatic duct were monitored before and during secretin stimulation. Duo denal filling volume was graded. Results were compared with those of e ndoscopic retrograde cholangiopancreatography and secretin stimulation testing with collection of pancreatic fluid. RESULTS: Secretin improv ed the delineation of ductal morphologic features in both groups. Pers istent dilatation of the pancreatic duct after stimulation (five patie nts) was a significant finding (P = .0015) in the diagnosis of papilla ry stenosis. The mean duodenal filling score was significantly lower i n patients with reduced exocrine function (six patients) than that in the volunteers (P < .0001). CONCLUSION: The use of dynamic MR pancreat ography with secretin stimulation may be useful for diagnosing pancrea tic papillary stenosis or dysfunction and for detecting reduced pancre atic exocrine reserve.