胰泌素增强磁共振胰胆管造影对健康成人胰腺外分泌功能的影响  

Quantitative analysis of pancreatic exocrine function in healthy adults using secretin-enhanced MRCP

作　　者：边云[1,2] 王莉[1] 陆建平[1] 武群[1] 陈士跃[1] 常乐[1] 谢丽娜[1] 

机构地区：[1]中国人民解放军第二军医大学长海医院医学影像科,上海市200434 [2]中国人民解放军第411医院医学影像科,上海市200081

出　　处：《世界华人消化杂志》2013年第11期978-983,共6页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;No.81070371~~

摘　　要：目的:探讨胰泌素刺激磁共振胰胆管造影(S-magnetic resonance cholangiopancreatograp hy,S-MRCP)半定量和定量对健康成人胰腺外分泌功能评估的价值.方法:回顾性分析17例健康志愿者的3.0TMR影像学资料,其中女5例,男12例,平均年龄44.0岁±14.4岁(24-64岁),体质量指数(body mass index,BMI)平均为24.5±13.4(18.9-31.1).对受试者进行冠状位T2加权扫描和MRCP、S-MRCP、常规胰腺水模(measurement phantoms,MP)检查,绘制出时间-胰液分泌量曲线,并计算出十二指肠内的胰液的流率和胰液分泌的达峰时间.结果:水模试验证实了MP测得的水的体积和实际水的体积有很好的相关性.健康人粪便中的粪弹性蛋白酶(fecal elastase 1,FE-1)的均值是301.55-673.20g/g,均值是525.4g/g±94.4g/g.注射胰泌素后10min胰液流率是平均为8.17mL/min±1.11mL/min(6.2-11mL/min,分泌量达峰时间平均为5.2min±1.2min(3-7min).结论:S-MRCP半定量测量可以用来初步评估胰腺的外分泌功能,S-MRCP可以定量测量、准确评估胰腺的外分泌功能.S-MRCP为临床提供一种安全、无创、高效的评估胰腺的外分泌功能的检查方法.AIM： To assess the value of secretin-enhanced magnetic resonance cholangiopancreatography （MRCP） and fecal elastase 1 （FE-1） tests for quantification of exocrine function in normal adults. METHODS： From April 2011 to January 2013, 17 healthy volunteers were enrolled in the study. There were 5 females and 12 males. Their median age was 44.0 years ± 14.4 years （24-64 years）, and their median BMI was 24.5 ± 13.4 （18.9-31.1）. Allsubjects had undergone both MRCP and FE-1. Coronal T2-weighted sequences and MRCP were performed before and at a 2 min interval after administration of 0.1 mL/kg secretin. Semiquantitative s-MRCP grading for duodenal filling was used to preliminarily assess the exocrine function of the pancreas. By drawing an appropriate region of interest, changes in signal intensity in the imaging volume were plotted against time and the flow rate derived from the gradient. Pancreatic exocrine secretions were quantified by pancreatic flow output （PFR） and peak time （PT）. RESULTS： Phantom experiments showed a good correlation between known and calculated volumes of water （P ＆lt; 0.001）. Ten minutes after secretin administration, 17 volunteers showed a duodenal filling beyond the genu inferius （grade 3）. Mean FE-1 was 353.3g/g ± 134.7g/g （range 201.55-673.20g/g）. Mean PFR was 8.17 mL/min ± 1.11 mL/min （range 6.2-11.0 mL/min）, and mean PT was 5.2 min ± 1.2 min （range 3-7 min）. There is a good correlation between PFR and FE-1 （P ＆lt; 0.001）. CONCLUSION： Semi-SMRCPQ can be used to preliminarily assess the exocrine function of the pancreas. SMRCP provides a safe, non-invasive, efficient method for evaluating the exocrine function of the pancreas.

关 键 词：胰腺外分泌功能 胰泌素 磁共振胰胆管成像 定量研究 

分 类 号：R576[医药卫生—消化系统]