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Madzak A, Engjom T, Wathle GK, Olesen SS, Tjora E, Njølstad PR, Lærum BN, Drewes AM, Dimcevski G, Frøkjær JB, Haldorsen IS. Secretin-stimulated MRI assessment of exocrine pancreatic function in patients with cystic fibrosis and healthy controls. Abdom Radiol (NY) 2017; 42:890-899. [PMID: 27832324 DOI: 10.1007/s00261-016-0972-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE Secretin-stimulated magnetic resonance imaging (s-MRI) and pancreatic diffusion weighted imaging (DWI) are novel non-invasive imaging techniques for assessment of exocrine pancreatic insufficiency (EPI). The aim was to validate s-MRI assessed pancreatic secreted volume using novel semi-automatic quantification software, and to assess the ability of s-MRI with DWI to diagnose EPI in patients with cystic fibrosis (CF). METHODS s-MRI and DWI was performed in 19 patients with CF (median age 21 years; range 16-56; eight men) and in 10 healthy controls (HC) (median age 46 years; range 20-65; four men). Sequential coronal T2-weighted images covering the duodenum and small bowel and axial DWI were acquired before and 1, 5, 9, and 13 min after secretin stimulation. A short endoscopic secretin test was used as reference method for EPI. RESULTS CF patients with EPI had lower apparent diffusion coefficient before secretin in the pancreatic head (P < 0.001) and lower secreted bowel fluid volumes (P = 0.035) compared to HC and CF patients without EPI. ROC curve analyses identified that secreted fluid volume after 13 min yielded the highest diagnostic accuracy for diagnosing EPI (AUC 0.93; 95% CI [0.80-1.00]). CONCLUSION Pancreatic s-MRI is useful for the assessment of exocrine pancreatic function with high diagnostic accuracy for the diagnosis of EPI in CF.
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Affiliation(s)
- Adnan Madzak
- Mech-Sense, Department of Radiology, Aalborg University Hospital, P.O. Box 365, 9100, Aalborg, Denmark.
| | - Trond Engjom
- Department of Clinical Medicine, University of Bergen, Mons, Norway
- Department of Medicine, Haukeland University Hospital, Mons, Norway
| | - Gaute K Wathle
- Department of Clinical Medicine, University of Bergen, Mons, Norway
- Department of Radiology, Haukeland University Hospital, Mons, Norway
| | - Søren Schou Olesen
- Centre for Pancreatic Diseases, Department of Gastroenterology & HepatologyAalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Erling Tjora
- Department of Clinical Science, University of Bergen, Mons, Norway
- Pediatric Department, Haukeland University Hospital, Mons, Norway
| | - Pål R Njølstad
- Department of Clinical Science, University of Bergen, Mons, Norway
- Pediatric Department, Haukeland University Hospital, Mons, Norway
| | - Birger Norderud Lærum
- Department of Clinical Science, University of Bergen, Mons, Norway
- Department of Thoracic Medicine, Haukeland University Hospital, Mons, Norway
| | - Asbjørn Mohr Drewes
- Centre for Pancreatic Diseases, Department of Gastroenterology & HepatologyAalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Georg Dimcevski
- Department of Clinical Medicine, University of Bergen, Mons, Norway
- Department of Medicine, Haukeland University Hospital, Mons, Norway
| | - Jens Brøndum Frøkjær
- Mech-Sense, Department of Radiology, Aalborg University Hospital, P.O. Box 365, 9100, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ingfrid S Haldorsen
- Department of Clinical Medicine, University of Bergen, Mons, Norway
- Department of Radiology, Haukeland University Hospital, Mons, Norway
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