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Normal pancreatic exocrine function does not exclude MRI/MRCP chronic pancreatitis findings
Samer Alkaade1, Numan Cem Balci, Amir Javad Momtahen
1Department of Internal Medicine, Division of Gastroenterology, Saint Louis University (SLU), Saint Louis, MO, USA. skaade@sbcglobal.net
Journal of Clinical Gastroenterology
|July 23, 2008
Summary
Normal pancreatic function tests do not rule out chronic pancreatitis. Magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) can reveal abnormalities even with normal function tests, suggesting early disease.
Area of Science:
- Gastroenterology and Hepatology
- Radiology and Medical Imaging
Background:
- Abnormal pancreatic function tests may precede imaging evidence of chronic pancreatitis.
- Magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) is a key tool for detecting early chronic pancreatitis.
- The study investigates MRI/MRCP in patients with suspected chronic pancreatitis and normal pancreatic function tests.
Purpose of the Study:
- To evaluate MRI/MRCP findings in patients presenting with symptoms of chronic pancreatitis but normal Secretin Endoscopic Pancreatic Function tests.
- To determine if MRI/MRCP can detect structural pancreatic changes despite normal functional test results.
Main Methods:
- Retrospective analysis of 32 patients with symptoms of chronic pancreatitis and normal initial abdominal imaging.
- All patients underwent Secretin Endoscopic Pancreatic Function testing and pancreatic MRI/MRCP.
- MRI/MRCP images were reviewed for duct morphology, gland characteristics, and enhancement patterns.
Main Results:
- Eight out of 23 patients with normal function tests showed abnormal MRI/MRCP findings, including duct stricture, dilatation, ectasia, atrophy, and decreased enhancement.
- Focal abnormalities were predominantly observed.
- Fifteen patients had completely normal MRI/MRCP findings.
Conclusions:
- Normal pancreatic function testing does not exclude the presence of abnormal MRI/MRCP findings in chronic pancreatitis.
- Focal MRI/MRCP abnormalities may indicate early or subclinical chronic pancreatitis.
- Further research is needed to establish definitive MRI/MRCP criteria for chronic pancreatitis diagnosis.
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