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Does secretin stimulation add to magnetic resonance cholangiopancreatography in characterising pancreatic cystic lesions as side-branch intraductal papillary mucinous neoplasm?

  • Hepatobiliary-Pancreas
  • Published:
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Abstract

Objectives

To assess the value of secretin during magnetic resonance cholangiopancreatography (MRCP) in demonstrating communication between cystic lesions and the pancreatic duct to help determine the diagnosis of side-branch intraductal papillary mucinous neoplasm (SB-IPMN).

Methods

This is an IRB-approved, HIPAA-compliant retrospective study of 29 SB-IPMN patients and 13 non-IPMN subjects (control) who underwent secretin-enhanced MRCP (s-MRCP). Two readers blinded to the final diagnosis reviewed three randomised image sets: (1) pre-secretin HASTE, (2) dynamic s-MRCP and (3) post-secretin HASTE. Logistic regression, generalised linear models and ROC analyses were used to compare pre- and post-secretin results.

Results

There was no significant difference in median scores for the pre-secretin [reader 1: 1; reader 2: 2 (range -2 to 2)] and post-secretin HASTE [reader 1: 1; reader 2: 1 (range -2 to 2)] in the SB-IPMN group (P = 0.14), while the scores were lower for s-MRCP [reader 1: 0.5 (range -2 to 2); reader 2: 0 (range -1 to 2); P = 0.016]. There was no significant difference in mean maximum diameter of SB-IPMN on pre- and post-secretin HASTE, and s-MRCP (P > 0.05).

Conclusion

Secretin stimulation did not add to MRCP in characterising pancreatic cystic lesions as SB-IPMN.

Key Points

• Magnetic resonance cholangiopancreatography (MRCP) is used to evaluate pancreatic cystic lesions.

• Intraductal papillary mucinous neoplasm (IPMN) is a type of pancreatic cystic neoplasm.

• Secretin administration does not facilitate the diagnosis of IPMN on MRCP.

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Abbreviations

MRCP:

magnetic resonance cholangiopancreatography

S-MRCP:

secretin-enhanced magnetic cholangiopancreatography

IPMN:

intraductal papillary mucinous neoplasm, SB-IPMN, side-branch intraductal papillary mucinous neoplasm

MDCT:

multidetector computed tomography

HASTE:

half-Fourier acquisition single-shot turbo spin-echo

MPD:

main pancreatic duct

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Acknowledgments

The scientific guarantor of this publication is Namita S. Gandhi, MD. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, diagnostic, performed at one institution

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Authors and Affiliations

  1. From the Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA

    Andrei S. Purysko, Namita S. Gandhi & Joseph C. Veniero

  2. Department of General Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA

    R. Mathew Walsh

  3. Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA

    Nancy A. Obuchowski

Authors
  1. Andrei S. Purysko
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  2. Namita S. Gandhi
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  3. R. Mathew Walsh
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  4. Nancy A. Obuchowski
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  5. Joseph C. Veniero
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Correspondence to Andrei S. Purysko.

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Purysko, A.S., Gandhi, N.S., Walsh, R.M. et al. Does secretin stimulation add to magnetic resonance cholangiopancreatography in characterising pancreatic cystic lesions as side-branch intraductal papillary mucinous neoplasm?. Eur Radiol 24, 3134–3141 (2014). https://doi.org/10.1007/s00330-014-3355-y

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  • DOI: https://doi.org/10.1007/s00330-014-3355-y

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