Evaluation of pancreatic secretion after administration of secretin: Application of magnetic resonance imaging

Background: To evaluate pancreatic exocrine function, we measured the chang es in T-2 enhanced hydrograhic intensity on magnetic resonance (MR) images of the pancreas following an injection of secretin, which is representative of the changes in duodenal fluid volume. Methods: The subjects were 10 patients with normal pancreatic function (N > 70% detected by using a pancreatic function diagnostant test) and 12 patie nts with hypo-function, including those with mild hypo-function (MH, 50-70% , six patients) and severe hypo-function (SH < 50%, six patients). Results: In the N group, T-2 enhanced intensity of the pancreas increased t o a maximum value (more than 10% compared with baseline) within 5 min of st imulation, then gradually decreased. No significant difference in the respo nse was observed between the head and body of the pancreas. Changes in the MH group were similar to those of the N group. In contrast, significantly l ower changes in T-2 enhanced intensity were observed in SH group, relative to both the N and MH group (P < 0.05). The amount of secretin-induced incre ase in duodenal fluid after 16 min was not significantly different among th e three groups. Furthermore, an evaluation of the residual pancreatic tissu e after a pancreatoduodenectomy was also feasible. Conclusions: Our results indicate that the MR-secretin test is useful for t he evaluation of severe pancreatic exocrine dysfunction. The diagnostic tes t is simple, direct and non-invasive. (C) 2001 Blackwell Science Asia Pry L td.