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Differences Noted in Pancreatic Perfusion at Rest, After Secretin Administration

November 30, -0001
Written by: , Filed in: Gastrointestinal Imaging
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The objective of a recent study was to assess pancreatic regional perfusion following dynamic contrast-enhanced MRI at rest and following secretin administration.

Participants
This study was comprised of 10 healthy volunteers aged 22 to 29 years who were without any history of pancreatic disease.

Methodology
Dynamic contrast-enhanced MRI was performed twice without and twice following secretin administration. There was a 1-week time interval between each of the 4 studies.

Examinations were performed with 1.5-T scanners. Dynamic contrast-enhanced imaging consisted of saturation-recovery T1-weighted turbo-field-echo sequence.

An external reference consisted of a standard manufacturer phantom composed of aqueous solution of copper sulfate, which was placed alongside the patient and included in the imaging field-of-view.

Regions of interest were drawn over the aorta, external reference phantom, pancreatic head, pancreatic body, and pancreatic tail. Careful attention was made to exclude vessels from pancreatic regions of interest.

Review for Practicing Radiologists The University of California, San Francisco School of Medicine, Department of Radiology and Biomedical Imaging Review for Practicing Radiologists an intensive clinical radiologic review and self-assessment covering the following radiology subspecialties: Vascular-Interventional, Breast, Neuro, Gastrointestinal and Pulmonary Imaging. The program is designed for radiologists in clinical practice. Click here to read more or order: Review for Practicing Radiologists

Results
There were no differences found in pancreatic perfusion values between the 2 dynamic-enhanced MRI sessions performed without secretin, or between the 2 sessions performed following secretin administration.

Dynamic contrast-enhanced images without secretin demonstrated a significant difference in perfusion values, with those of the head being significantly lower than those of the body and tail.

There were significant differences between the head and body and between the head and tail, while no significant difference was noted between the body and tail.

Following secretin administration, there was a significant difference in perfusion values found between the body and tail. However, increased mean pancreatic perfusion values were found following secretin administration in all 3 regions.

The increasing perfusion was more pronounced in the pancreatic head, which was not the case during examinations without secretin where perfusion values were lower.

Reviewer’s Comments
Dynamic contrast-enhanced MRI demonstrates an increase in pancreatic regional perfusion following secretin administration.

The results of this study are useful in that they illustrate significant differences in pancreatic perfusion both at rest and following secretin administration. Consequently, these findings could potentially be helpful in patients with pancreatic disease.

In particular, differences in pancreatic regional perfusion may be beneficial in evaluating the extent of insult during an acute episode of pancreatitis.

The findings can also potentially aid in estimating the amount of pancreatic reserve in patients with chronic disease.

A limitation noted in this study was the lack of a reference standard for quantitative measurement of pancreatic perfusion.

Author: John C. Sabatino, MD, MSD

Reference:
Bali, MA, Metens, T., et al. Pancreatic Perfusion: Noninvasive Quantitative Assessment With Dynamic Contrast-Enhanced MR Imaging Without and With Secretin Stimulation in Healthy Volunteers–Initial Results. Radiology; 2008; 247 (April): 115-121

Review for Practicing Radiologists The University of California, San Francisco School of Medicine, Department of Radiology and Biomedical Imaging Review for Practicing Radiologists an intensive clinical radiologic review and self-assessment covering the following radiology subspecialties: Vascular-Interventional, Breast, Neuro, Gastrointestinal and Pulmonary Imaging. The program is designed for radiologists in clinical practice. Click here to read more or order: Review for Practicing Radiologists
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