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Eur J Radiol. 2015 Apr;84(4):575-80. doi: 10.1016/j.ejrad.2014.12.028. Epub 2015 Jan 13.

Incremental value of secretin-enhanced magnetic resonance cholangiopancreatography in detecting ductal communication in a population with high prevalence of small pancreatic cysts.

Author information

1
Departments of Medicine (Gastroenterology) and Radiology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Medical Institutions, United States.
2
Mayo Clinic, United States.
3
MD Anderson Cancer Center, United States.
4
Beth Israel Deaconess Medical Center, United States.
5
Dana Farber Cancer Institute, United States.
6
University of California, Los Angeles, United States.
7
Departments of Medicine (Gastroenterology) and Radiology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Medical Institutions, United States. Electronic address: ikamel@jhmi.edu.

Abstract

PURPOSE:

We investigated the incremental diagnostic yield of S-MRCP in a population with high prevalence of small pancreatic cysts.

METHODS:

Standard MRCP protocol was performed with and without secretin using 1.5 T units in subjects undergoing pancreatic screening because of a strong family history of pancreatic cancer as part of the multicenter Cancer of the Pancreas Screening-3 trial (CAPS 3). All studies were reviewed prospectively by two independent readers who recorded the presence and number of pancreatic cysts, the presence of visualized ductal communication before and after secretin, and the degree of confidence in the diagnoses.

RESULT:

Of 202 individuals enrolled (mean age 56 years, 46% males), 93 (46%) had pancreatic cysts detected by MRCP, and 64 of the 93 had pre-and post-secretin MRCP images available for comparison. Data from the 128 readings show that 6 (6/128=4.7%) had ductal communication visualized only on the secretin studies compared to pre-secretin studies (odds ratio 1.28, p=0.04). In addition, there was a statistically significant increase in confidence in reporting ductal communication after secretin compared to before secretin (p<0.0005).

CONCLUSION:

At 1.5 T MRI, the use of secretin can improve the visualization of ductal communication of cystic pancreatic lesions.

KEYWORDS:

Cyst; Magnetic resonance imaging; Neoplasm; Pancreas; Screening; Secretin

PMID:
25619503
PMCID:
PMC5024538
DOI:
10.1016/j.ejrad.2014.12.028
[Indexed for MEDLINE]
Free PMC Article

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