Related Experiment Videos
MR cholangiopancreatography in children: feasibility, safety, and initial experience
Lisa Delaney1, Kimberly E Applegate, Boaz Karmazyn
1Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA.
Insights
Magnetic resonance cholangiopancreatography (MRCP) is safe and accurate for visualizing children's pancreaticobiliary anatomy. Its use, especially with secretin, enhances pancreatic duct visualization, aiding diagnosis.
Area of Science:
- Pediatric Radiology
- Gastroenterology
- Medical Imaging
Background:
- Indications, safety, and findings of MR cholangiopancreatography (MRCP) in children are not well-described and may differ from adults.
- Limited data exists on the pediatric application of MRCP.
Purpose of the Study:
- To investigate the safety, feasibility, and diagnostic accuracy of MRCP in pediatric patients.
- To evaluate the impact of secretin administration on MRCP image quality in children.
Main Methods:
- Prospective review of 85 pediatric MRCP studies, analyzing indications, secretin use, and outcomes.
- Two radiologists assessed image quality and pancreatic duct visualization before and after secretin.
- Statistical analysis compared MRCP findings with ERCP where performed and analyzed factors influencing abnormal studies.
Main Results:
- MRCP demonstrated excellent image quality in 85% of pediatric studies (n=85).
- Abnormal MRCP findings were more frequent in girls and those who underwent ERCP.
- Secretin administration significantly improved pancreatic duct visualization (P<0.001) and was well-tolerated.
Conclusions:
- MRCP is a safe and accurate imaging modality for pediatric pancreaticobiliary anatomy.
- Secretin enhances pancreatic duct visualization during pediatric MRCP, improving diagnostic utility.
Background:
The indications for MR cholangiopancreatography (MRCP) in children, and its safety and findings, might differ from those in adults and are not well described.
Objective:
To investigate the safety, feasibility, and accuracy of MRCP in children.
Materials And Methods:
We reviewed all prospective MRCP reports, noting the indication, the use of secretin, endoscopic retrograde cholangiopancreatography (ERCP) findings, and patient outcomes. Two readers reviewed each MRCP study by consensus to rate duct visualization and compare pancreatic duct sizes before and after secretin administration (paired t-test). The likelihood of a normal versus an abnormal MRCP study was compared by gender, pancreatitis as the primary indication, secretin use, and whether ERCP was performed (Fisher's exact test), as well as age (t-test).
Results:
A total of 85 MRCP studies were performed in children (mean age 10.3 years), most commonly for evaluation of pancreatitis (n=47, 55%); 41 (48%) used secretin and 39 (46%) used a negative oral contrast agent. Of the 85 studies, 72 (85%) had excellent image quality and 43 were normal. ERCP was performed after 16 of the 85 MRCP studies (19%); the diagnoses were concordant with those of MRCP in 13 (81%). There were 42 abnormal MRCP studies, and these were more likely to be in girls (P=0.03) and in children who had undergone ERCP (P<0.01). Secretin and the negative oral contrast agent were well-tolerated. Secretin improved duct visualization (P<0.001).
Conclusion:
MRCP safely and accurately depicted pancreaticobiliary anatomy in children. The use of secretin improved visualization of the pancreatic duct.
