Kazuya Yasokawa1, Katsuyoshi Ito2, Akihiko Kanki2, Akira Yamamoto2, Teruyuki Torigoe2, Tomohiro Sato2, Tsutomu Tamada2. 1. Department of Diagnostic Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan. Electronic address: roentgen@med.kawasaki-m.ac.jp. 2. Department of Diagnostic Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan.
Abstract
PURPOSE: To evaluate the correlation between the pancreatic exocrine insufficiency estimated by cine-dynamic MRCP using spatially selective IR pulse and the severity stages (modified Cambridge classification) based on morphological changes of the pancreatic duct in patients with suspected chronic pancreatitis. MATERIALS AND METHODS: Thirty-nine patients with suspected chronic pancreatitis underwent cine-dynamic MRCP with a spatially selective IR pulse. The secretion grading score (5-point scale) based on the moving distance of pancreatic juice inflow on cine-dynamic MRCP was assessed, and compared with the stage of the severity of chronic pancreatitis based on morphological changes of pancreatic duct. RESULT: The stage of the severity of chronic pancreatitis based on morphological changes had significant negative correlations with the secretion grade (r=-0.698, P<0.001). The secretion grading score of stage 4 was significantly lower than stage 1-3 (P<0.001, P=0.002, P=0.025, respectively). In all 19 patients in stage 4, the secretion grading score was <0.70. The secretion grading score of stage 1 was significantly higher than stage 2 and 4 (P=0.019, P<0.001, respectively). In stage 2, the secretion grading score was <0.70 in 8 (89%) of 9 patients showing pancreatic exocrine insufficiency. Conversely, in stage 3, the secretion grading score was >0.70 in 2 (33%) of 6 patients showing normal pancreatic exocrine function. CONCLUSION: It should be noted that the degree of morphological changes of pancreatic duct does not necessarily reflect the severity of pancreatic exocrine insufficiency at cine-dynamic MRCP in stage 2-3 chronic pancreatitis.
PURPOSE: To evaluate the correlation between the pancreatic exocrine insufficiency estimated by cine-dynamic MRCP using spatially selective IR pulse and the severity stages (modified Cambridge classification) based on morphological changes of the pancreatic duct in patients with suspected chronic pancreatitis. MATERIALS AND METHODS: Thirty-nine patients with suspected chronic pancreatitis underwent cine-dynamic MRCP with a spatially selective IR pulse. The secretion grading score (5-point scale) based on the moving distance of pancreatic juice inflow on cine-dynamic MRCP was assessed, and compared with the stage of the severity of chronic pancreatitis based on morphological changes of pancreatic duct. RESULT: The stage of the severity of chronic pancreatitis based on morphological changes had significant negative correlations with the secretion grade (r=-0.698, P<0.001). The secretion grading score of stage 4 was significantly lower than stage 1-3 (P<0.001, P=0.002, P=0.025, respectively). In all 19 patients in stage 4, the secretion grading score was <0.70. The secretion grading score of stage 1 was significantly higher than stage 2 and 4 (P=0.019, P<0.001, respectively). In stage 2, the secretion grading score was <0.70 in 8 (89%) of 9 patients showing pancreatic exocrine insufficiency. Conversely, in stage 3, the secretion grading score was >0.70 in 2 (33%) of 6 patients showing normal pancreatic exocrine function. CONCLUSION: It should be noted that the degree of morphological changes of pancreatic duct does not necessarily reflect the severity of pancreatic exocrine insufficiency at cine-dynamic MRCP in stage 2-3 chronic pancreatitis.