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Secretin-stimulated MRI assessment of exocrine pancreatic function in patients with cystic fibrosis and healthy controls

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Abstract

Purpose

Secretin-stimulated magnetic resonance imaging (s-MRI) and pancreatic diffusion weighted imaging (DWI) are novel non-invasive imaging techniques for assessment of exocrine pancreatic insufficiency (EPI). The aim was to validate s-MRI assessed pancreatic secreted volume using novel semi-automatic quantification software, and to assess the ability of s-MRI with DWI to diagnose EPI in patients with cystic fibrosis (CF).

Methods

s-MRI and DWI was performed in 19 patients with CF (median age 21 years; range 16–56; eight men) and in 10 healthy controls (HC) (median age 46 years; range 20–65; four men). Sequential coronal T2-weighted images covering the duodenum and small bowel and axial DWI were acquired before and 1, 5, 9, and 13 min after secretin stimulation. A short endoscopic secretin test was used as reference method for EPI.

Results

CF patients with EPI had lower apparent diffusion coefficient before secretin in the pancreatic head (P < 0.001) and lower secreted bowel fluid volumes (P = 0.035) compared to HC and CF patients without EPI. ROC curve analyses identified that secreted fluid volume after 13 min yielded the highest diagnostic accuracy for diagnosing EPI (AUC 0.93; 95% CI [0.80–1.00]).

Conclusion

Pancreatic s-MRI is useful for the assessment of exocrine pancreatic function with high diagnostic accuracy for the diagnosis of EPI in CF.

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Abbreviations

CF:

Cystic fibrosis

HC:

Healthy controls

EPI:

Exocrine pancreatic insufficiency

s-MRI:

Secretin-stimulated magnetic resonance imaging

DWI:

Diffusion weighted imaging

ADC:

Apparent diffusion coefficient

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Author information

Authors and Affiliations

  1. Mech-Sense, Department of Radiology, Aalborg University Hospital, P.O. Box 365, 9100, Aalborg, Denmark

    Adnan Madzak & Jens Brøndum Frøkjær

  2. Department of Clinical Medicine, University of Bergen, Mons, Norway

    Trond Engjom, Gaute K. Wathle, Georg Dimcevski & Ingfrid S. Haldorsen

  3. Department of Medicine, Haukeland University Hospital, Mons, Norway

    Trond Engjom & Georg Dimcevski

  4. Department of Radiology, Haukeland University Hospital, Mons, Norway

    Gaute K. Wathle & Ingfrid S. Haldorsen

  5. Centre for Pancreatic Diseases, Department of Gastroenterology & HepatologyAalborg University Hospital, Aalborg, Denmark

    Søren Schou Olesen & Asbjørn Mohr Drewes

  6. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

    Søren Schou Olesen, Asbjørn Mohr Drewes & Jens Brøndum Frøkjær

  7. Department of Clinical Science, University of Bergen, Mons, Norway

    Erling Tjora, Pål R. Njølstad & Birger Norderud Lærum

  8. Pediatric Department, Haukeland University Hospital, Mons, Norway

    Erling Tjora & Pål R. Njølstad

  9. Department of Thoracic Medicine, Haukeland University Hospital, Mons, Norway

    Birger Norderud Lærum

Authors
  1. Adnan Madzak
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  2. Trond Engjom
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  3. Gaute K. Wathle
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  4. Søren Schou Olesen
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  5. Erling Tjora
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  7. Birger Norderud Lærum
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  8. Asbjørn Mohr Drewes
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  9. Georg Dimcevski
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  10. Jens Brøndum Frøkjær
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  11. Ingfrid S. Haldorsen
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Corresponding author

Correspondence to Adnan Madzak.

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No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

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.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Madzak, A., Engjom, T., Wathle, G.K. et al. Secretin-stimulated MRI assessment of exocrine pancreatic function in patients with cystic fibrosis and healthy controls. Abdom Radiol 42, 890–899 (2017). https://doi.org/10.1007/s00261-016-0972-8

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  • DOI: https://doi.org/10.1007/s00261-016-0972-8

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