Secretin-Enhanced MRCP: How and Why-AJR Expert Panel Narrative Review

Area of Science:

• Radiology
• Gastroenterology
• Medical Imaging

Background:

• Standard MRCP has limitations in fully assessing pancreaticobiliary anatomy and function.
• Secretin stimulation enhances pancreatic fluid secretion, offering a dynamic imaging approach.

Purpose of the Study:

• To provide a comprehensive review of secretin-enhanced MRCP (S-MRCP) implementation and interpretation.
• To detail the practical aspects of S-MRCP, including patient preparation and acquisition techniques.
• To outline established and emerging indications for S-MRCP in diagnosing pancreaticobiliary conditions.

Main Methods:

• This narrative review synthesizes information on S-MRCP techniques and applications.
• It covers patient preparation, secretin administration, and dynamic imaging acquisition protocols.
• Interpretation guidelines focus on pancreatic duct compliance and duodenal fluid dynamics.

Main Results:

• S-MRCP enhances visualization of ductal anatomy and provides functional pancreatic insights.
• Established indications include pancreas divisum, anomalous pancreaticobiliary junction, and chronic pancreatitis.
• Emerging indications involve acute pancreatitis, exocrine function, and pancreatic neoplasms.

Conclusions:

• S-MRCP offers significant advantages over standard MRCP for pancreaticobiliary imaging.
• The technique provides crucial functional information, aiding in the diagnosis of diverse pancreatic diseases.
• S-MRCP is a valuable tool for radiologists in evaluating complex pancreaticobiliary conditions.