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Quantitative MRCP assessment of pancreatic exocrine reserve and its correlation with faecal elastase-1 in patients with chronic pancreatitis

Valutazione quantitativa della riserva pancreatica esocrina per mezzo della colangiopancreatografia con risonanza magnetica e sua correlazione con l’elastasi fecale-1 nei pazienti con pancreatite cronica

  • Abdominal Radiology / Radiologia Addominale
  • Published:
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Abstract

Purpose

This retrospective study was done to correlate a quantitative assessment of the pancreatic exocrine reserve by dynamic secretin magnetic resonance cholangiopancreatography (MRCPQ) with the faecal elastase-1 (FE-1) test in patients with chronic pancreatitis.

Materials and methods

Thirty-five patients with a clinical diagnosis of chronic (CP) or acute recurrent (ARP) pancreatitis were enrolled. FE-1 was indicative of the pancreatic exocrine reserve. Subsequently, the patient population was subdivided into two groups according to a clinical threshold value of 200 μg/g. All patients underwent MRCP examination during secretin administration. Duodenal filling volume was calculated on T2-weigthed rapid acquisition with relaxation enhancement (RARE) MRCP images obtained 10 min after secretin injection. Duodenal filling volumes were compared with FE-1 values. Scatter plots, Pearson correlation coefficient and the Mann-Whitney U test were performed.

Results

Thirty-five paired MRCPQ-FE1 data sets were analysed. MRCPQ was significantly different (p=0.007) between patients with impaired and preserved pancreatic function; median and interquartile range (IQR) were 150.7 ml (137.3–205.5 ml; n=9) and 332.4 ml (190.6–506.9 ml; n=26). Both Pearson correlation coefficient (p<0.001) and the Mann-Whitney U test (p=0.007) were significant.

Conclusions

MRCPQ significantly correlates with FE-1 values. It is possible to discriminate impaired and preserved pancreatic exocrine function using MRCPQ.

Riassunto

Obiettivo

Scopo del presente studio è stato identificare una correlazione tra la valutazione quantitativa della riserva pancreatica esocrina tramite l’utilizzo della colangiopancreatografia con risonanza magnetica durante lo stimolo secretinico (CPRMQ) ed il test della elastasi fecale-1 (FE-1) nei pazienti con pancreatite cronica.

Materiali e metodi

Trentacinque pazienti con una diagnosi clinica di pancreatite cronica o di pancreatiti acute ricorrenti sono stati reclutati in questo studio retrospettico. I valori di FE-1 sono stati utilizzati per quantificare la riserva pancreatica esocrina; successivamente i pazienti sono stati suddivisi in due gruppi a seconda di un valore soglia clinico di FE-1 di 200 μg/g. Tutti i pazienti sono stati sottoposti a CPRM con stimolo secretinico. Il volume di riempimento duodenale è stato calcolato su immagini CPRM rapid acquisition with relaxation enhancement (RARE) T2-dipendenti, ottenute 10 min dopo l’iniezione di secretina. I volumi di riempimento duodenale sono stati comparati con il valore di FE-1. Sono stati valutati grafici di dispersione, il coefficiente di correlazione di Pearson ed il test U di Mann-Whitney.

Risultati

Trentacinque coppie di dati CPRMQ-FE-1 sono state analizzate. La CPRMQ è risultata significativamente differente (p=0,007) tra il gruppo con funzione pancreatica ridotta e quello con funzione normale; mediana e range interquartilico (IQR) sono stati di 150,7 ml (137,3-205,5 ml; n=9) e 332,4 ml (190,6-506,9 ml; n=26). Sia il coefficiente di correlazione di Pearson (p<0,001) che il test U di Mann-Whitney (p=0,007) si sono dimostrati significativi.

Conclusioni

La CPRM quantitativa correla positivamente con i valori FE-1. è possibile discriminare una funzione pancreatica esocrina conservata da una ridotta per mezzo della CPRMQ.

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Authors and Affiliations

  1. Istituto di Radiologia, Università di Verona, Policlinico “G.B. Rossi”, Piazzale L.A. Scuro, 37134, Verona, Italy

    R. Manfredi, S. Perandini, N. Faccioli & R. Pozzi Mucelli

  2. Istituto di Scienze Chirurgiche e Biomediche, Università di Verona, Policlinico “G.B. Rossi”, Piazzale L.A. Scuro, 37134, Verona, Italy

    L. Frulloni

  3. Istituto di Medicina e Salute Pubblica, Università di Verona, Policlinico “G.B. Rossi”, Piazzale L.A. Scuro, 37134, Verona, Italy

    W. Mantovani

Authors
  1. R. Manfredi
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  2. S. Perandini
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  3. W. Mantovani
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  4. L. Frulloni
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  5. N. Faccioli
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  6. R. Pozzi Mucelli
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Correspondence to R. Manfredi.

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Manfredi, R., Perandini, S., Mantovani, W. et al. Quantitative MRCP assessment of pancreatic exocrine reserve and its correlation with faecal elastase-1 in patients with chronic pancreatitis. Radiol med 117, 282–292 (2012). https://doi.org/10.1007/s11547-011-0774-6

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  • DOI: https://doi.org/10.1007/s11547-011-0774-6

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