Pancreatic transplants: noninvasive evaluation with secretin-augmented mr pancreatography and MR perfusion measurements--preliminary results.

Abstract

Feasibility of secretin-augmented magnetic resonance (MR) pancreatography and dynamic contrast material-enhanced MR measurements for evaluation of functional status of pancreatic allografts was determined by quantifying the excretion and perfusion of the grafts. Ten patients were included prospectively before pancreatic transplantation. Dynamic T2-weighted sequences after secretin stimulation and dynamic contrast-enhanced T1-weighted gradient-echo sequences were performed. Area under the curve and maximum signal intensity-to-time ratio were determined in selected regions of interest. Biochemical parameters, Doppler ultrasonography, and/or surgery were standards for final diagnosis. Patients with normal outcome (n = 7) produced 236 mL +/- 104 (standard deviation) of pancreatic juice, and patients with dysfunctional grafts (n = 3) produced 42 mL +/- 25. Area under the curve and maximum signal intensity-to-time ratio provided thresholds of 0.5 and 0.3, respectively, for distinction between functional and dysfunctional grafts. Secretin-augmented MR pancreatography combined with MR perfusion measurements may aid in differentiation between patients with and those without graft dysfunction.