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Pancreatic transplants: secretin-stimulated MR pancreatography

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Abstract

Background

Our study was aimed to evaluate the functional status of pancreatic transplants using dynamic MR pancreatography after secretin stimulation.

Methods

Thirteen asymptomatic patients previously submitted to isolated pancreas (n = 6) or combined kidney–pancreas (n = 7) transplantation, with enteric-portal pancreatic drainage, underwent MR examination at 1.5 T using a phased-array coil. After the acquisition of axial and coronal T1- and T2-weighted sequences, dynamic MR pancreatography was performed using a coronal breath-hold, thick-slab (40–60 mm), single-shot T2-weighted fast spin-echo sequence. After the intravenous administration of secretin (Secrelux®, Sanochemia; 1 cU/kg body/weight), a single-slice image acquisition was repeated every 30 s up to 15 min. We estimated the calibre changes of the pancreatic ductal system and the filling of the donor’s duodenum on the basis of pancreatic secretion after secretin stimulation, also evaluated by using a mean signal intensity/time histogram in a chosen region of interest including the transplanted pancreas and the connected small bowel.

Results

All patients well tolerated the examination, and no side effects were reported after secretin administration. In 12/13 cases, a significant increase (more than 1 mm) in the diameter of the mean pancreatic duct was observed after secretin stimulation; in all patients, a noticeable filling of the duodenal graft was demonstrated during dynamic MR pancreatography on both qualitative and quantitative analyses.

Conclusions

Dynamic MR imaging after secretin administration allows non-invasive evaluation of exocrine function of the pancreatic transplants and could be used to differentiate patients with graft rejection from those with normal graft function.

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Acknowledgments

The authors thank Angelo Ferrara and Claudio Moriani for their important contribution in performing the procedures.

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Authors and Affiliations

  1. 2nd Department of Radiology, Pisa University Hospital, Via Paradisa 2, 56124, Pisa, Italy

    Piero Boraschi, Francescamaria Donati, Roberto Gigoni & Fabio Falaschi

  2. Diagnostic and Interventional Radiology of the Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Via Roma 67, 56125, Pisa, Italy

    Francesco Odoguardi, Emanuele Neri & Carlo Bartolozzi

  3. General and Transplantation Surgery of the Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Via Roma 67, 56125, Pisa, Italy

    Ugo Boggi

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  1. Piero Boraschi
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  2. Francescamaria Donati
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  3. Roberto Gigoni
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  4. Francesco Odoguardi
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  5. Emanuele Neri
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  6. Ugo Boggi
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  7. Fabio Falaschi
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  8. Carlo Bartolozzi
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Correspondence to Piero Boraschi.

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Boraschi, P., Donati, F., Gigoni, R. et al. Pancreatic transplants: secretin-stimulated MR pancreatography. Abdom Imaging 32, 207–214 (2007). https://doi.org/10.1007/s00261-007-9178-4

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  • DOI: https://doi.org/10.1007/s00261-007-9178-4

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