Abdominal Radiology

, Volume 42, Issue 2, pp 544–551 | Cite as

Detection of exocrine dysfunction by MRI in patients with early chronic pancreatitis

  • Temel TirkesEmail author
  • Evan L. Fogel
  • Stuart Sherman
  • Chen Lin
  • Jordan Swensson
  • Fatih Akisik
  • Kumaresan Sandrasegaran



To determine if T1-weighted MR signal of the pancreas can be used to detect early CP.


A retrospective analysis was performed on 51 suspected CP patients, who had both secretin-enhanced magnetic resonance cholangiopancreatography (S-MRCP) and an intraductal secretin stimulation test (IDST). There were 29 patients in normal and 22 patients in the low bicarbonate group. Bicarbonate level, total pancreatic juice volume, and excretory flow rate were recorded during IDST. Signal intensity ratio of pancreas (SIR), fat signal fraction, pancreatograms findings, and grade of duodenal filling were recorded on S-MRCP by two blinded radiologists.


There was a significant difference in the signal intensity ratio of the pancreas to spleen (SIRp/s) between the normal and low bicarbonate groups (p < 0.0001). A significant positive correlation was found between pancreatic fluid bicarbonate level and SIRp/s (p < 0.0001). SIRp/s of 1.2 yielded sensitivity of 77% and specificity of 83% for detection of pancreatic exocrine dysfunction (AUC: 0.89).


T1-weighted MR signal of the pancreas has a high sensitivity and specificity for the detection of parenchymal abnormalities related to exocrine dysfunction and can therefore be helpful in evaluation of suspected early CP.


Chronic pancreatitis Secretin stimulation test Magnetic resonance imaging Exocrine Dysfunction 


Compliance with ethical standards


No funding was received for this work.

Conflict of interest

Authors do not have any relevant conflict of interest with this study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. T1

his article does not contain any studies with animals performed by any of the authors.

Informed consent

Requirement for an informed consent was waived by the IRB.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Temel Tirkes
    • 1
    Email author
  • Evan L. Fogel
    • 2
  • Stuart Sherman
    • 2
  • Chen Lin
    • 1
  • Jordan Swensson
    • 1
  • Fatih Akisik
    • 1
  • Kumaresan Sandrasegaran
    • 1
  1. 1.Department of Radiology and Clinical SciencesIndiana University School of MedicineIndianapolisUSA
  2. 2.Division of Gastroenterology, Department of MedicineIndiana University School of MedicineIndianapolisUSA

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