The utility of secretin-enhanced MRCP in diagnosing congenital anomalies

Purpose To assess the additional value of secretin-enhanced MRCP (SMRCP) over conventional MRCP in diagnosing divisum. Methods Retrospective HIPAA-compliant and IRB-approved review found 140 patients with SMRCP and ERCP correlation within 6 months of each other. All studies were anonymized and the S...

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Published in:Abdominal imaging 2014-10, Vol.39 (5), p.979-987
Main Authors: Sandrasegaran, Kumaresan, Cote, Gregory A., Tahir, Bilal, Ahmad, Iftikhar, Tann, Mark, Akisik, Fatih M., Lall, Chandana G., Sherman, Stuart
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Cholangiopancreatography, Magnetic Resonance - methods
Diagnosis, Differential
Female
Gastroenterology
Hepatology
Humans
Imaging
Male
Medicine
Medicine & Public Health
Middle Aged
Pancreas - abnormalities
Pancreas - pathology
Radiology
Reproducibility of Results
Retrospective Studies
Secretin
Sensitivity and Specificity
Young Adult
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Summary:Purpose To assess the additional value of secretin-enhanced MRCP (SMRCP) over conventional MRCP in diagnosing divisum. Methods Retrospective HIPAA-compliant and IRB-approved review found 140 patients with SMRCP and ERCP correlation within 6 months of each other. All studies were anonymized and the SMRCP images (SMRCP image set) were separated from 2D and 3D MRCP and axial and coronal T2-weighted images (conventional MRI image set). Each image set on each patient was assigned different and randomized case numbers. Two reviewers (R1 and R2) independently reviewed the image sets for divisum vs. no divisum, complete divisum vs. incomplete divisum, and the certainty of diagnosis (1 = definitely certain, 2 = moderately certain, and 3 = unsure). ERCP findings were taken as gold standard. Results There was no difference in age and gender between the divisum ( n  = 97, with 13 incomplete divisum) and no divisum ( n  = 43) groups. In diagnosing divisum anatomy, the sensitivity was higher for SMRCP compared to conventional MRI for R1 (84.5 vs. 72.2, p  = 0.02) but not R2 (89.7 vs. 84.4, p  = 0.25). The specificity was higher in SMRCP image set compared to conventional MRI ( R 1: 88.1 vs. 76.2, p  = 0.01; R 2: 81.4 vs. 65.1, p  
ISSN:0942-8925
2366-004X
1432-0509
2366-0058
DOI:10.1007/s00261-014-0131-z