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Secretin-enhanced MRCP: proceed with cautious optimism.

Abstract
Magnetic resonance imaging (MRI) is a safe and universally available test that has much appeal to generalists and subspecialists evaluating patients with pancreatic disease. Testoni et al. report the clinical utility of magnetic resonance pancreaticocholangiography (MRCP) and secretin-enhanced MRCP in the evaluation of patients with asymptomatic abnormalities in pancreatic enzymes. The authors report that chronic pancreatitis changes will be seen in up to a third of patients with asymptomatic elevations in pancreas enzymes when compared with age-matched controls. The changes described on MRI and secretin-enhanced MRI are not in question, but the clinical significance of these changes is unknown. The authors rightly report that some of the changes seen may be age related, nonspecific, and of unknown clinical significance. Any new imaging and diagnostic test needs to be interpreted with caution until appropriate prospective clinical trials have been performed. It appears that secretin stimulation enhances the diagnostic accuracy of MRCP for the detection of minor changes in the pancreatic duct and parenchyma. Gastroenterologists are encouraged to proceed with cautious optimism when using MRI for the evaluation of early chronic pancreatitis.
AuthorsNisha I Sainani, Darwin L Conwell
JournalThe American journal of gastroenterology (Am J Gastroenterol) Vol. 104 Issue 7 Pg. 1787-9 (Jul 2009) ISSN: 1572-0241 [Electronic] United States
PMID19455128 (Publication Type: Comparative Study, Editorial, Comment)
Chemical References
  • Secretin
  • Amylases
Topics
  • Amylases (blood, metabolism)
  • Cholangiopancreatography, Magnetic Resonance (methods)
  • Early Diagnosis
  • Female
  • Humans
  • Image Enhancement (methods)
  • Male
  • Pancreatic Ducts (abnormalities, pathology)
  • Pancreatitis, Chronic (diagnosis, enzymology)
  • Risk Assessment
  • Secretin
  • Sensitivity and Specificity

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