Santorinicele: secretin-enhanced magnetic resonance cholangiopancreatography findings before and after minor papilla sphincterotomy

详细信息    查看全文

• 作者：Enrico Boninsegna ; Riccardo Manfredi ; Anna Ventriglia…
• 关键词：Secretin ; enhanced MRCP ; Pancreas divisum ; Santorinicele ; Minor papilla sphincterotomy ; MRI
• 刊名：European Radiology
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：25
• 期：8
• 页码：2437-2444
• 全文大小：446 KB
• 参考文献：1.Manfredi R, Brizi MG, Tancioni V, Vecchioli A, Marano P (2001) Magnetic resonance pancreatography (MRP): morphology and function. Rays 26:127-33PubMed
  2.Manfredi R, Brizi MG, Costamagna G, Masselli G, Vecchioli Scaldazza A, Marano P (2002) Pancreas divisum and Santorinicele: assessment by dynamic magnetic resonance cholangiopancreatography during secretin stimulation. Radiol Med 103:55-4PubMed
  3.Liao Z, Gao R, Wang W et al (2009) A systematic review on endoscopic detection rate, endotherapy, and surgery for pancreas divisum. Endoscopy 41:439-44PubMed View Article
  4.Lerner A, Branski D, Lebenthal E (1996) Pancreatic diseases in children. Pediatr Clin North Am 43:125-56PubMed View Article
  5.Gonoi W, Akai H, Hagiwara K et al (2011) Pancreas divisum as a predisposing factor for chronic and recurrent idiopathic pancreatitis: initial in vivo survey. Gut 60:1103-108PubMed View Article
  6.Stern CD (1986) A historical perspective on the discovery of the accessory duct of the pancreas, the ampulla 'of Vater' and pancreas divisum. Gut 27:203-12PubMed Central PubMed View Article
  7.Griffin N, Charles-Edwards G, Grant LA (2012) Magnetic resonance cholangiopancreatography: the ABC of MRCP. Insights Imaging 3:11-1PubMed Central PubMed View Article
  8.Cotton PB (1980) Congenital anomaly of pancreas divisum as cause of obstructive pain and pancreatitis. Gut 21:105-14PubMed Central PubMed View Article
  9.Gregg JA (1977) Pancreas divisum: its association with pancreatitis. Am J Surg 134:539-43PubMed View Article
  10.Eisen G, Schutz S, Metzler D, Baillie J, Cotton PB (1994) Santorinicele: new evidence for obstruction in pancreas divisum. Gastrointest Endosc 40:73-6PubMed View Article
  11.Seibert DG, Matulis SR (1995) Santorinicele as a cause of chronic pancreatic pain. Am J Gastroenterol 90:121-23PubMed
  12.Bret PM, Reinhold C, Taourel P, Guibaud L, Atri M, Barkun AN (1996) Pancreas divisum: evaluation with MR cholangiopancreatography. Radiology 199:99-03PubMed View Article
  13.Matos C, Metens T, Deviere J et al (1997) Pancreatic duct: morphologic and functional evaluation with dynamic MR pancreatography after secretin stimulation. Radiology 203:435-41PubMed View Article
  14.Manfredi R, Costamagna G, Vecchioli A, Colagrande C, Spina S, Marano P (1998) Dynamic pancreatography with magnetic resonance after functional stimulus with secretin in chronic pancreatitis. Radiol Med 96:226-31PubMed
  15.Nicaise N, Pellet O, Metens T et al (1998) Magnetic resonance cholangiopancreatography: interest of IV secretin administration in the evaluation of pancreatic ducts. Eur Radiol 8:16-2PubMed View Article
  16.Manfredi R, Costamagna G, Brizi MG et al (2000) Pancreas divisum and "Santorinicele": diagnosis with dynamic MR cholangiopancreatography with secretin stimulation. Radiology 217:403-08PubMed View Article
  17.Costamagna G, Ingrosso M, Tringali A, Mutignani M, Manfredi R (2000) Santorinicele and recurrent acute pancreatitis in pancreas divisum: diagnosis with dynamic secretin-stimulated magnetic resonance pancreatography and endoscopic treatment. Gastrointest Endosc 52:262-67PubMed View Article
  18.Lutzak GD, Gluck M, Ross AS, Kozarek RA (2013) Endoscopic minor papilla sphincterotomy in patients with Santoriniceles reduces pain and improves quality of life. Dig Dis Sci 58:2075-081PubMed View Article
  19.Frulloni L, Falconi M, Gabbrielli A et al (2010) Italian consensus guidelines for chronic pancreatitis. Dig Liver Dis 42(Suppl 6):S381–S406PubMed View Article
  20.Quest L, Lombard M (2000) Pancreas divisum: opinio divisa. Gut 47:317-19PubMed Central PubMed View Article
  21.Spicak J, Poulova P, Plucnarova J, Rehor M, Filipova H, Hucl T (2007) Pancreas divisum does not modify the natural course of chronic pancreatitis. J Gastroenterol 42:135-39PubMed View Article
  22.Kamisawa T, Yuyang T, Egawa N, Ishiwata J, Okamoto A (1998) Patency of the accessory pancreatic duct in relation to its course and shape: a dye-injection endoscopic retrograde pancreatography study. Am J Gastroenterol 93:2135-140PubMed View Article
  23.Rosch W, Koch H, Schaffner O, Demling L (1976) The clinical significance of the pancreas divisum. Gastrointest Endosc 22:206-07PubMed View Article
  24.Benage D, McHenry R, Hawes RH, O'Connor KW, Lehman GA (1990) Minor papilla cannulation and dorsal ductography in pancreas divisum. Gastrointest Endosc 36:553-57PubMed View Article
  25.Delhaye M, Engelholm L, Cremer M (1985) Pancreas divisum: congenital anatomic variant or anomaly? Contribution of endoscopic retrograde dorsal pancreatography. Gastroenterology 89:951-58PubMed
  26.DiMagno MJ, Wamsteker EJ (2011) Pancreas divisum. Curr Gastroenterol Rep 13:150-56PubMed Central PubMed View Article
  27.Fukukura Y, Fujiyoshi F, Sasaki M, Nakajo M (2002) Pancreatic duct: morphologic evaluation with MR cholangiopancreatography after secretin stimulation. Radiology 222:674-80PubMed V
• 作者单位：Enrico Boninsegna (1)
  Riccardo Manfredi (1)
  Anna Ventriglia (1)
  Riccardo Negrelli (1)
  Beatrice Pedrinolla (1)
  Sara Mehrabi (1)
  Armando Gabbrielli (2)
  Roberto Pozzi Mucelli (1)
  
  1. Department of Radiology - Policlinico G.B. Rossi, University of Verona, P.le L.A. Scuro 10, Verona, Italy
  2. Department of Medicine - Policlinico G.B. Rossi, University of Verona, Verona, Italy
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Diagnostic Radiology
  Interventional Radiology
  Neuroradiology
  Ultrasound
  Internal Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-1084

文摘

Objectives To evaluate secretin-enhanced MRCP (S-MRCP) findings of patients with pancreas divisum and Santorinicele, before and after minor papilla sphincterotomy. Methods S-MRCP examinations of 519 patients with suspected pancreatic disease were included. Size of the main pancreatic duct, presence and calibre of Santorinicele were evaluated. Duodenal filling was assessed on dynamic images. After sphincterotomy the same parameters and the clinical findings were re-evaluated. Results Pancreas divisum was depicted in 55/519 patients (11?%) by MRCP and an additional 26/519 by S-MRCP (total 81/519, 16?%). Santorinicele was detected in 7/81 patients (8.6?%) with pancreas divisum by MRCP and an additional 20/81 by S-MRCP (total 27/81, 33?%). Dorsal duct in patients with Santorinicele was significantly larger in the head compared with patients with only pancreas divisum (p-lt;-.01), in basal conditions (average 2.4 versus 1.9?mm) and after secretin administration (average 3.0 versus 2.4?mm). Duodenal filling was impaired in 11/27 patients (41?%) with Santorinicele. After sphincterotomy significant reduction in size of Santorinicele (?3?%) and dorsal duct (?7?%), increase of pancreatic juice and symptoms improvement were observed. Conclusion Secretin administration increases the accuracy of MRCP in detecting Santorinicele and demonstrates the impaired duodenal filling. S-MRCP is useful to assess results of sphincterotomy. Key Points -Secretin-enhanced MRCP gives anatomical and functional information on pancreatic outflow dynamics. -Santorinicele is a cystic dilatation of the termination of the Santorini duct. -S-MRCP images are the most useful to recognize the presence of Santorinicele. -Minor papilla sphincterotomy during ERCP is indicated in patients with Santorinicele.