Prospective Assessment of Normal Pancreatic Secretory Function Measured by MRI in a Cohort of Healthy Children

Am J Gastroenterol. 2018 Sep;113(9):1385. doi: 10.1038/s41395-018-0190-9. Epub 2018 Jul 5.

Abstract

Objectives: Magnetic resonance imaging (MRI) with secretin stimulation promises to allow non-invasive testing for exocrine pancreatic insufficiency but normal data do not exist for children. The purpose of this study was to define, in healthy children, normal pancreatic secreted fluid volume and secretion rate, measured by MRI, in response to secretin.

Methods: In this Institutional Review Board-approved, prospective, cross-sectional study, 50 healthy children ages 6 to <16 years underwent MRI with secretin stimulation. Images were obtained before and at 1, 5, 10 and 15 min after secretin administration to calculate total secreted fluid volume and secretion rate based on image segmentation. Regression was used to define the relationship between secretory function and participant size measures, and linear quantile regression was used to define normal secretory values based on size measures.

Results: Median total secreted fluid volume post secretin was 79 mL (range: 32-162 mL; 5th and 95th percentiles: 43 and 123 mL) and median secretion rate was 5.1 mL/min (range: 2-9.4 mL/min; 5th and 95th percentiles: 2.3 and 7.7 mL/min). Secreted volume and secretion rate had the strongest correlation with body surface area (BSA) (r = 0.54 and 0.59, respectively) and multiple regression defined BSA as the only significant predictor of secretory function. Each 1 m2 increase in BSA was associated with a 38 mL increase in secreted fluid volume.

Conclusions: In children, pancreatic secretory response to secretin, measured by MRI, depends on participant size, particularly BSA. Secreted volume <43 mL or a secretion rate <2.3 mL/min (5th percentile values) can be considered abnormal for children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Body Surface Area
  • Child
  • Cholangiopancreatography, Magnetic Resonance
  • Cross-Sectional Studies
  • Female
  • Healthy Volunteers
  • Humans
  • Injections, Intravenous
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Imaging / standards*
  • Male
  • Pancreas, Exocrine / diagnostic imaging
  • Pancreas, Exocrine / drug effects
  • Pancreas, Exocrine / metabolism*
  • Pancreatic Function Tests / methods
  • Pancreatic Function Tests / standards*
  • Pancreatic Juice / metabolism
  • Prospective Studies
  • Reference Values
  • Secretin / administration & dosage

Substances

  • Secretin