Advertisement

Abdominal Imaging

, Volume 33, Issue 4, pp 469–473 | Cite as

Correlation of MRCP quantification (MRCPQ) with conventional non-invasive pancreatic exocrine function tests

  • Alice GillamsEmail author
  • Stephen Pereira
  • George Webster
  • William Lees
Article

Abstract

Purpose

To correlate MRCP quantification (MRCPQ) of pancreatic fluid output following secretin with steatorrhoea, urinary pancreo-lauryl (PL) or fecal elastase 1 (FE1) tests.

Methods and materials

Sixty-one patients, 36 male, median age 51 years (23–78) with known or suspected pancreatic disease who had undergone both MRCPQ and FE1 or PL were included. Twenty-nine patients had chronic pancreatitis, five acute pancreatitis, seven normal, five pancreas divisum, four pancreatic atrophy, three pancreatic duct obstruction, two post-surgical and six miscellaneous diagnoses. Clinical assessment of steatorrhoea was available in 29. MRCP was performed before and at 2 min intervals after 0.1 ml/kg IV Secretin. Changes in signal intensity in the imaging volume were plotted against time and the flow rate derived from the gradient. Scatter plots, Pearson correlation coefficient, and the Fisher Exact test were performed.

Results

MRCPQ was significantly different (p = 0.012) between those with/without steatorrhoea; mean ± SD (95% CI) were 4.0 ± 1.5 (3.1:4.9, n = 16) and 6.3 ± 2.9 (4.7:7.8, n = 13). Fifty-one paired FE1-MRCPQ and 24 PL-MRCPQ data sets were analysed. Both the Pearson correlation coefficient (FE1 p = 0.001 and %TK p = 0.003) and the Fisher Exact test were significant (FE1 p = 0.016 and %T/K 0.03).

Conclusions

MRCPQ correlated with steatorrhoea, PL and FE1.

Keywords

MRCP Pancreatitic disease Pancreatic exocrine function Secretin Steatorrhoea 

Reference

  1. 1.
    Leodolter A, Kahl S, Dominguez-Munoz JE, et al. (2000) Comparison of two tubeless function tests in the assessment of mild-to-moderate exocrine pancreatic insufficiency. Eur J Gastroenterol Hepatol 12:1335–1338PubMedCrossRefGoogle Scholar
  2. 2.
    Gullo L, Ventrucci M, Tomassetti P, et al. (1999) Fecal elastase 1 determination in chronic pancreatitis. Dig Dis Sci 44:210–213PubMedCrossRefGoogle Scholar
  3. 3.
    Ventrucci M, Gullo L, Daniele C, et al. (1983) Pancreolauryl test for pancreatic exocrine insufficiency. Am J Gastroenterol 78:806–809PubMedGoogle Scholar
  4. 4.
    Lankisch PG, Schmidt I, Konig H, et al. (1998) Faecal elastase 1: not helpful in diagnosing chronic pancreatitis associated with mild to moderate exocrine pancreatic insufficiency. Gut 42:551–554PubMedCrossRefGoogle Scholar
  5. 5.
    Siegmund E, Lohr J, Schuff-Werner P (2004) The diagnostic validity of non-invasive pancreatic function tests—a meta-analysis. Z Gastroenterol 10:1117–1128CrossRefGoogle Scholar
  6. 6.
    Elphick D, Kapur K (2005) Comparing the urinary pancreolauryl ratio and faecal elastase-1 as indicators of pancreatic insufficiency in clinical practice. Pancreatology 5:196–200PubMedCrossRefGoogle Scholar
  7. 7.
    Brydon WG, Kingstone K, Ghosh S (2004) Limitations of faecal elastase-1 and chymotrypsin as tests of exocrine pancreatic disease in adults. Ann Clin Biochem 41:78–81PubMedCrossRefGoogle Scholar
  8. 8.
    Manfredi R, Brizi MG, Tancioni V, et al. (2001) Magnetic resonance pancreatography (MRP): morphology and function. Rays 26:127–133PubMedGoogle Scholar
  9. 9.
    Matos C, Metens T, Deviere J, et al. (1997) Pancreatic duct: morphologic and functional evaluation with dynamic MR pancreatography after secretin stimulation. Radiology 203:435–441PubMedGoogle Scholar
  10. 10.
    Punwani S, Gillams AR, Lees WR (2003) Non-invasive quantification of pancreatic exocrine function using secretin-stimulated MRCP. Eur Radiol 13:273–276PubMedGoogle Scholar
  11. 11.
    Gillams AR, Pereira S, Lees WR (2003) Secretin MRCP Quantification in Pancreatic Disease. Radiology pp 49Google Scholar
  12. 12.
    Schibli S, Corey M, Gaskin KJ, et al. (2006) Towards the ideal quantitative pancreatic function test: analysis of test variables that influence validity. Clin Gastroenterol Hepatol 4:90–97PubMedCrossRefGoogle Scholar
  13. 13.
    Draganov P, Patel A, Fazel A, et al. (2005) Prospective evaluation of the accuracy of the intraductal secretin stimulation test in the diagnosis of chronic pancreatitis. Clin Gastroenterol Hepatol 3:695–699PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Alice Gillams
    • 1
    Email author
  • Stephen Pereira
    • 2
  • George Webster
    • 2
  • William Lees
    • 1
  1. 1.Medical ImagingUniversity College London Medical School and HospitalsLondonUnited Kingdom
  2. 2.GastroenterologyUniversity College London Medical School and HospitalsLondonUnited Kingdom

Personalised recommendations