Secretin-enchanced magneticresonance cholangiopancreatography for the functional assessment of pancreatic exocrine insufficiency
Pl. Getzov, M. Kovacheva-Slavova, S. Mitova-Siminkovich, B. Vladimirov
Chronic pancreatitis is a progressive inflammatory disease, which diagnosis is based on changes of the pancreatic gland’s morphology and function. The morphological changes are assessed by imaging techniques, including computer tomography and magnetic resonance imaging. The pancreatic exocrine function is evaluated by direct and indirect tests. Direct functional tests use secretin and cholecystokinin to measure the quantity of pancreatic secretion and its bicarbonate/ enzyme content. Although their high sensitivity and specificity, nowadays their application is limited. The secretin enhanced magnetic resonance imaging combines both morphology and functional assessment of pancreatic gland. During the investigation the morphological changes are evaluated by presecretin magnetic resonance cholangiopancreatography and are classified according to the Cambridge criteria for chronic pancreatitis. Pancreatic exocrine function is defined by a semi-quantitative assessment of postsecretin duodenal filling on the 10th minute and by additional ductal criteria after secretin application.
Key words: CHRONIC PANCREATITIS. PANCREATIC EXOCRINE FUNCTION. SECRETIN-ENHANCED MRCP