Dynamic Secretin-enhanced MR Cholangiopancreatography

Studies have shown that Secretin

Enhanced MRCP improves visual clarity

by sharpening images.

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INTRODUCTION

Magnetic resonance (MR) cholangiopancreatography is a noninvasive technique for evaluation of the pancreatic ducts and biliary tree. The method has been available for more than a decade and is based on the use of heavily T2-weighted MR sequences to suppress the signal from most soft tissues and allow the stationary fluid in the ducts to be visualized. Use of a contrast agent is not necessary at MR cholangiopancreatography, and the imaging examination is often performed without it. However, we have found that the use of secretin, a hormone that stimulates pancreatic secretion, improves our ability to assess the pancreatic duct system. In this article, we discuss and illustrate the utility of secretin-enhanced MR cholangiopancreatography in the detection of various pancreatic diseases.  http://radiographics.rsna.org/content/26/3/665.full

Figure 5a. Complete pancreas divisum. (a)Presecretin MR image does not clearly depict the main pancreatic duct. (b) MR image obtained 5 minutes after secretin injection clearly shows the main duct in the body of the pancreas (white arrow) and the dorsal duct (arrowhead) in continuity with the main duct. Note that the main duct does not join with the distal common bile duct (black arrow), a finding that indicates complete pancreas divisum.(c) Corresponding ERCP image obtained after injection via the minor papilla helps confirm pancreas divisum and shows a santorinicele (arrow) at the minor papilla.

Figure 5b. Complete pancreas divisum. (a) Presecretin MR image does not clearly depict the main pancreatic duct. (b) MR image obtained 5 minutes after secretin injection clearly shows the main duct in the body of the pancreas (white arrow) and the dorsal duct (arrowhead) in continuity with the main duct. Note that the main duct does not join with the distal common bile duct (black arrow), a finding that indicates complete pancreas divisum.(c) Corresponding ERCP image obtained after injection via the minor papilla helps confirm pancreas divisum and shows a santorinicele (arrow) at the minor papilla.

figure 5c. Complete pancreas divisum. (a) Presecretin MR image does not clearly depict the main pancreatic duct. (b) MR image obtained 5 minutes after secretin injection clearly shows the main duct in the body of the pancreas (white arrow) and the dorsal duct (arrowhead) in continuity with the main duct. Note that the main duct does not join with the distal common bile duct (black arrow), a finding that indicates complete pancreas divisum.(c) Corresponding ERCP image obtained after injection via the minor papilla helps confirm pancreas divisum and shows a santorinicele (arrow) at the minor papilla.

figure a

figure b

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CONCLUSIONS

Secretin is a safe, albeit costly, agent that improves visualization of the main and side pancreatic ducts in normal and pathologic states during MR cholangiopancreatography. Dynamic MR cholangiopancreatography after secretin administration also provides valuable information about the secretory reserve capacity of the pancreas. Yet, a lack of awareness of the value of secretin-enhanced MR cholangiopancreatography among radiologists and referring clinicians has limited the use of this technique.  http://radiographics.rsna.org/content/26/3/665.full

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Diffusion-Weighted MR Imaging: Applications in the Body

D.-M. Koh, Harriet C. Thoeny “Diffusion-Weig

hted MR Imaging: Applications in the Body”
Springer | English | 2009-12-03 | ISBN3540785752 | 299 pages | PDF | 87,6 MB

BOOK DESCRIPTION

The clinical applications of diffusion-weighted MR imaging (DW-MRI) in the body are rapidly evolving. This volume highlights state-of-the-art techniques for performing DW-MRI measurement in the body and addresses important practical issues. Key points are highlighted that will help radiologists and technologists to acquire high-quality images for disease assessment and to adapt the technique to their own clinical practice or research. The major clinical applications of DW-MRI in the body, both oncological and non-oncological, are extensively illustrated, providing readers with a broad insight into the growing uses of the technique. The final section addresses future developments, considering the potential importance of the technique in relation to drug development and the ways in which DW-MRI might be combined with other functional imaging techniques to further improve disease assessment.

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