Clinical Usefulness of Secretin-enhanced Magnetic Resonance Cholangiopancreatography on Various Pancreatic Diseases

Background/Aims: Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive diagnostic technique for evaluation of the pancreatic duct, but it has several limitations compared with endoscopic retrograde cholangio pancreatography. The aim of this study was to assess the usefulness and clinical indication of secretin-enhanced MRCP (S-MRCP) in patients with vatious pancreatic diseases. Methods: From 2001 to 2002, S-MRCP was performed in 47 patients with chronic pancreatitis (group 1, n=19), pancreas divisum (group 2, n=11), acute pancreatitis (group 3, n=8), and other pancreatic diseases (group 4, n=9). Image quality and presence of pancreas divisum were analyzed before and 10 minutes after the IV administration of 1 CU/kg secretin. Size of the main pancreatic duct and improvement scale before and after secretin stimulation were measured quantitatively. Results: After administration of secretin, image quality was significantly improved in all four groups. However, such improvement was significantly lower in group 1 of chronic pancreatitis than in other groups. The S-MRCP has changed treatment plan, especially in patients with acute necrotizing pancreatitis or pancreas divisum. Conclusions: The administration of secretin improves visualization of all pancreatic disease. Especiallys, S-MRCP would be useful as a primary diagnostics tool for assessment of patients to be suspected of having acute necrotizing pancreatitis or pancreas divisum.