TY - JOUR
T1 - Editorial
T2 - Secretin-enhanced MRCP: Proceed with cautious optimism
AU - Sainani, Nisha I.
AU - Conwell, Darwin L.
PY - 2009/7
Y1 - 2009/7
N2 - 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.
AB - 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.
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U2 - 10.1038/ajg.2009.168
DO - 10.1038/ajg.2009.168
M3 - Review article
C2 - 19455128
AN - SCOPUS:67650417890
SN - 0002-9270
VL - 104
SP - 1787
EP - 1789
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 7
ER -