Usefulness of dynamic magnetic resonance pancreatography with secretin [correction of secretion] injection for evaluating pancreatic exocrine function after pancreatogastric reconstructive surgery

Background/Purpose: The usefulness of dynamic magnetic resonance pancreatography (MRP) with secretin injection as a new method of assessing pancreatic exocrine function was evaluated in patients undergoing pancreatogastrostomy. Methods: A series of 12 patients who had undergone pancreatogastrostomy were classified into group 1 (9 patients whose pancreas was normal preoperatively) and group 2 (3 patients with a firm pancreas accompanied by distended pancreatic ducts). The pancreatic exocrine function was evaluated using the changes in maximum pancreatic duct diameter and the intensity ratio calculated by tracing the contour line on the images of pancreatic juice secretion newly occurring after dynamic MRP with prior secretin injection. Results: Clear visualization of the pancreatic duct by MRP was achieved in all 12 patients, and a decrease in pancreatic duct diameter was evident postoperatively in group 2. Pancreatic juice secretion was well visualized on MRP images following secretin injection in 10 patients but not in 2 patients of group 2. Higher intensity ratios were noted in group 1 than in group 2. Conclusions: Dynamic MRP with secretion injection enables clear verification of pancreatic juice secretion on images and permits objective evaluation of pancreatic exocrine function. It therefore is a useful procedure for assessing pancreatic exocrine function after resection of the pancreas. Received: August 16, 2001 / Accepted: August 5, 2002 Acknowledgments. The authors extend their gratitude to Ms. Megumi Nakajima for her helpful collaboration in MRP image processing. Offprint requests to: S. Ohhigashi