Magnetic resonance imaging in assessment of pancreatic exocrine function: current status_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUANG Zixing ¹ , WANG Chengwei ² , LIU Ling ³ ,  SONG Bin ¹

1. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Integrated Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

SONG Bin, Email: cjr.songbin@vip.163.com

Keywords：

magnetic resonance imaging; exocrine function of pancreas; magnetic resonance cholangiopancreatography; diffusion-weighted imaging

DOI：

10.7507/1007-9424.201910090

Video：

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Objective To summarize the application of magnetic resonance imaging (MRI) in the evaluation of pancreatic exocrine function.Method In this paper, we reviewed and summarized the related literatures about the application of MRI in the field of pancreatic exocrine function evaluation in recent years.Results A variety of MRI techniques could be used to detect the pancreatic exocrine function. In addition to conventional MRI techniques, there were also MRI stimulated by pancreatic secretions, cine (dynamic) cholangiopancreatography based on space selective reverse recovery pulse, and so on.Conclusion The new MRI techniques have potential for semi-quantitative and quantitative evaluation of pancreatic exocrine function.

Citation： HUANG Zixing, WANG Chengwei, LIU Ling, SONG Bin. Magnetic resonance imaging in assessment of pancreatic exocrine function: current status. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(12): 1476-1479. doi: 10.7507/1007-9424.201910090 Copy

1.	陸建平. 胰腺病理影像學. 上海: 上海科學技術出版社, 2019: 19-23.
2.	中國醫師協會胰腺病專業委員會慢性胰腺炎專委會. 胰腺外分泌功能不全診治規范 (2018, 廣州). 臨床肝膽病雜志, 2019, 35(2): 294-298.
3.	Forsmark CE. Diagnosis and management of exocrine pancreatic insufficiency. Curr Treat Options Gastroenterol, 2018, 16(3): 306-315.
4.	Capurso G, Traini M, Piciucchi M, et al. Exocrine pancreatic insufficiency: prevalence, diagnosis, and management. Clin Exp Gastroenterol, 2019, 12: 129-139.
5.	Abu-El-Haija M, Conwell DL. Pancreatic insufficiency: what is the gold standard? Gastrointest Endosc Clin N Am, 2018, 28(4): 521-528.
6.	Durie P, Baillargeon JD, Bouchard S, et al. Diagnosis and management of pancreatic exocrine insufficiency (PEI) in primary care: consensus guidance of a Canadian expert panel. Curr Med Res Opin, 2018, 34(1): 25-33.
7.	Tirkes T, Fogel EL, Sherman S, et al. Detection of exocrine dysfunction by MRI in patients with early chronic pancreatitis. Abdom Radiol (NY), 2017, 42(2): 544-551.
8.	Madzak A, Olesen SS, Haldorsen IS, et al. Secretin-stimulated MRI characterization of pancreatic morphology and function in patients with chronic pancreatitis. Pancreatology, 2017, 17(2): 228-236.
9.	Miyake H, Sakagami J, Yasuda H, et al. Association of fatty pancreas with pancreatic endocrine and exocrine function. PLoS One, 2018, 13(12): e0209448.
10.	Madzak A, Engjom T, Wathle GK, et al. Secretin-stimulated MRI assessment of exocrine pancreatic function in patients with cystic fibrosis and healthy controls. Abdom Radiol (NY), 2017, 42(3): 890-899.
11.	Chey WY, Chang TM. Secretin, 100 years later. J Gastroenterol, 2003, 38(11): 1025-1035.
12.	Ito K, Torigoe T, Tamada T, et al. The secretory flow of pancreatic juice in the main pancreatic duct: visualization by means of MRCP with spatially selective inversion-recovery pulse. Radiology, 2011, 261(2): 582-586.
13.	Mensel B, Messner P, Mayerle J, et al. Secretin-stimulated MRCP in volunteers: assessment of safety, duct visualization, and pancreatic exocrine function. AJR Am J Roentgenol, 2014, 202(1): 102-108.
14.	Matos C, Metens T, Devière J, et al. Pancreatic duct: morphologic and functional evaluation with dynamic MR pancreatography after secretin stimulation. Radiology, 1997, 203(2): 435-441.
15.	Manfredi R, Costamagna G, Brizi MG, et al. Severe chronic pancreatitis versus suspected pancreatic disease: dynamic MR cholangiopancreatography after secretin stimulation. Radiology, 2000, 214(3): 849-855.
16.	Punwani S, Gillams AR, Lees WR. Non-invasive quantification of pancreatic exocrine function using secretin-stimulated MRCP. Eur Radiol, 2003, 13(2): 273-276.
17.	Manfredi R, Perandini S, Mantovani W, et al. Quantitative MRCP assessment of pancreatic exocrine reserve and its correlation with faecal elastase-1 in patients with chronic pancreatitis. Radiol Med, 2012, 117(2): 282-292.
18.	Sanyal R, Stevens T, Novak E, et al. Secretin-enhanced MRCP: review of technique and application with proposal for quantification of exocrine function. AJR Am J Roentgenol, 2012, 198(1): 124-132.
19.	Bian Y, Wang L, Chen C, et al. Quantification of pancreatic exocrine function of chronic pancreatitis with secretin-enhanced MRCP. World J Gastroenterol, 2013, 19(41): 7177-7182.
20.	Wathle GK, Tjora E, Ersland L, et al. Assessment of exocrine pancreatic function by secretin-stimulated magnetic resonance cholangiopancreaticography and diffusion-weighted imaging in healthy controls. J Magn Reson Imaging, 2014, 39(2): 448-454.
21.	Bali MA, Sontou R, Arvanitakis M, et al. Evaluation of the stimulating effect of a low dose of secretin compared to the standard dose on the exocrine pancreas with MRCP: preliminary results in normal subjects (MRCP quantification of secretin stimulation). Abdom Imaging, 2007, 32(6): 743-748.
22.	Trout AT, Serai SD, Fei L, et al. Prospective assessment of normal pancreatic secretory function measured by MRI in a cohort of healthy children. Am J Gastroenterol, 2018, 113(9): 1385.
23.	邊云, 王莉, 陸建平, 等. 胰泌素增強磁共振胰膽管造影對健康成人胰腺外分泌功能的影響. 世界華人消化雜志, 2013, 21(11): 978-983.
24.	Torigoe T, Ito K, Yamamoto A, et al. Age-related change of the secretory flow of pancreatic juice in the main pancreatic duct: evaluation with cine-dynamic MRCP using spatially selective inversion recovery pulse. AJR Am J Roentgenol, 2014, 202(5): 1022-1026.
25.	Yasokawa K, Ito K, Tamada T, et al. Postprandial changes in secretory flow of pancreatic juice in the main pancreatic duct: evaluation with cine-dynamic MRCP with a spatially selective inversion-recovery (IR) pulse. Eur Radiol, 2016, 26(12): 4339-4344.
26.	Yasokawa K, Ito K, Tamada T, et al. Noninvasive investigation of exocrine pancreatic function: feasibility of cine dynamic MRCP with a spatially selective inversion-recovery pulse. J Magn Reson Imaging, 2015, 42(5): 1266-1271.
27.	Yamamoto A, Ito K, Yasokawa K, et al. Symptoms that are associated with decreased pancreatic enzyme flow: MRCP assessment. J Magn Reson Imaging, 2019, 50(2): 417-423.
28.	Yasokawa K, Ito K, Kanki A, et al. Evaluation of pancreatic exocrine insufficiency by cine-dynamic MRCP using spatially selective inversion-recovery (IR) pulse: correlation with severity of chronic pancreatitis based on morphological changes of pancreatic duct. Magn Reson Imaging, 2018, 48: 70-73.

1. 陸建平. 胰腺病理影像學. 上海: 上海科學技術出版社, 2019: 19-23.
2. 中國醫師協會胰腺病專業委員會慢性胰腺炎專委會. 胰腺外分泌功能不全診治規范 (2018, 廣州). 臨床肝膽病雜志, 2019, 35(2): 294-298.
3. Forsmark CE. Diagnosis and management of exocrine pancreatic insufficiency. Curr Treat Options Gastroenterol, 2018, 16(3): 306-315.
4. Capurso G, Traini M, Piciucchi M, et al. Exocrine pancreatic insufficiency: prevalence, diagnosis, and management. Clin Exp Gastroenterol, 2019, 12: 129-139.
5. Abu-El-Haija M, Conwell DL. Pancreatic insufficiency: what is the gold standard? Gastrointest Endosc Clin N Am, 2018, 28(4): 521-528.
6. Durie P, Baillargeon JD, Bouchard S, et al. Diagnosis and management of pancreatic exocrine insufficiency (PEI) in primary care: consensus guidance of a Canadian expert panel. Curr Med Res Opin, 2018, 34(1): 25-33.
7. Tirkes T, Fogel EL, Sherman S, et al. Detection of exocrine dysfunction by MRI in patients with early chronic pancreatitis. Abdom Radiol (NY), 2017, 42(2): 544-551.
8. Madzak A, Olesen SS, Haldorsen IS, et al. Secretin-stimulated MRI characterization of pancreatic morphology and function in patients with chronic pancreatitis. Pancreatology, 2017, 17(2): 228-236.
9. Miyake H, Sakagami J, Yasuda H, et al. Association of fatty pancreas with pancreatic endocrine and exocrine function. PLoS One, 2018, 13(12): e0209448.
10. Madzak A, Engjom T, Wathle GK, et al. Secretin-stimulated MRI assessment of exocrine pancreatic function in patients with cystic fibrosis and healthy controls. Abdom Radiol (NY), 2017, 42(3): 890-899.
11. Chey WY, Chang TM. Secretin, 100 years later. J Gastroenterol, 2003, 38(11): 1025-1035.
12. Ito K, Torigoe T, Tamada T, et al. The secretory flow of pancreatic juice in the main pancreatic duct: visualization by means of MRCP with spatially selective inversion-recovery pulse. Radiology, 2011, 261(2): 582-586.
13. Mensel B, Messner P, Mayerle J, et al. Secretin-stimulated MRCP in volunteers: assessment of safety, duct visualization, and pancreatic exocrine function. AJR Am J Roentgenol, 2014, 202(1): 102-108.
14. Matos C, Metens T, Devière J, et al. Pancreatic duct: morphologic and functional evaluation with dynamic MR pancreatography after secretin stimulation. Radiology, 1997, 203(2): 435-441.
15. Manfredi R, Costamagna G, Brizi MG, et al. Severe chronic pancreatitis versus suspected pancreatic disease: dynamic MR cholangiopancreatography after secretin stimulation. Radiology, 2000, 214(3): 849-855.
16. Punwani S, Gillams AR, Lees WR. Non-invasive quantification of pancreatic exocrine function using secretin-stimulated MRCP. Eur Radiol, 2003, 13(2): 273-276.
17. Manfredi R, Perandini S, Mantovani W, et al. Quantitative MRCP assessment of pancreatic exocrine reserve and its correlation with faecal elastase-1 in patients with chronic pancreatitis. Radiol Med, 2012, 117(2): 282-292.
18. Sanyal R, Stevens T, Novak E, et al. Secretin-enhanced MRCP: review of technique and application with proposal for quantification of exocrine function. AJR Am J Roentgenol, 2012, 198(1): 124-132.
19. Bian Y, Wang L, Chen C, et al. Quantification of pancreatic exocrine function of chronic pancreatitis with secretin-enhanced MRCP. World J Gastroenterol, 2013, 19(41): 7177-7182.
20. Wathle GK, Tjora E, Ersland L, et al. Assessment of exocrine pancreatic function by secretin-stimulated magnetic resonance cholangiopancreaticography and diffusion-weighted imaging in healthy controls. J Magn Reson Imaging, 2014, 39(2): 448-454.
21. Bali MA, Sontou R, Arvanitakis M, et al. Evaluation of the stimulating effect of a low dose of secretin compared to the standard dose on the exocrine pancreas with MRCP: preliminary results in normal subjects (MRCP quantification of secretin stimulation). Abdom Imaging, 2007, 32(6): 743-748.
22. Trout AT, Serai SD, Fei L, et al. Prospective assessment of normal pancreatic secretory function measured by MRI in a cohort of healthy children. Am J Gastroenterol, 2018, 113(9): 1385.
23. 邊云, 王莉, 陸建平, 等. 胰泌素增強磁共振胰膽管造影對健康成人胰腺外分泌功能的影響. 世界華人消化雜志, 2013, 21(11): 978-983.
24. Torigoe T, Ito K, Yamamoto A, et al. Age-related change of the secretory flow of pancreatic juice in the main pancreatic duct: evaluation with cine-dynamic MRCP using spatially selective inversion recovery pulse. AJR Am J Roentgenol, 2014, 202(5): 1022-1026.
25. Yasokawa K, Ito K, Tamada T, et al. Postprandial changes in secretory flow of pancreatic juice in the main pancreatic duct: evaluation with cine-dynamic MRCP with a spatially selective inversion-recovery (IR) pulse. Eur Radiol, 2016, 26(12): 4339-4344.
26. Yasokawa K, Ito K, Tamada T, et al. Noninvasive investigation of exocrine pancreatic function: feasibility of cine dynamic MRCP with a spatially selective inversion-recovery pulse. J Magn Reson Imaging, 2015, 42(5): 1266-1271.
27. Yamamoto A, Ito K, Yasokawa K, et al. Symptoms that are associated with decreased pancreatic enzyme flow: MRCP assessment. J Magn Reson Imaging, 2019, 50(2): 417-423.
28. Yasokawa K, Ito K, Kanki A, et al. Evaluation of pancreatic exocrine insufficiency by cine-dynamic MRCP using spatially selective inversion-recovery (IR) pulse: correlation with severity of chronic pancreatitis based on morphological changes of pancreatic duct. Magn Reson Imaging, 2018, 48: 70-73.

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Magnetic resonance imaging in assessment of pancreatic exocrine function: current status

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