Article | Published:

Prospective Assessment of Normal Pancreatic Secretory Function Measured by MRI in a Cohort of Healthy Children

The American Journal of Gastroenterologyvolume 113pages13851392 (2018) | Download Citation

Subjects

Abstract

Objectives

Magnetic resonance imaging (MRI) with secretin stimulation promises to allow non-invasive testing for exocrine pancreatic insufficiency but normal data do not exist for children. The purpose of this study was to define, in healthy children, normal pancreatic secreted fluid volume and secretion rate, measured by MRI, in response to secretin.

methods

In this Institutional Review Board-approved, prospective, cross-sectional study, 50 healthy children ages 6 to <16 years underwent MRI with secretin stimulation. Images were obtained before and at 1, 5, 10 and 15 min after secretin administration to calculate total secreted fluid volume and secretion rate based on image segmentation. Regression was used to define the relationship between secretory function and participant size measures, and linear quantile regression was used to define normal secretory values based on size measures.

Results

Median total secreted fluid volume post secretin was 79 mL (range: 32–162 mL; 5th and 95th percentiles: 43 and 123 mL) and median secretion rate was 5.1 mL/min (range: 2–9.4 mL/min; 5th and 95th percentiles: 2.3 and 7.7 mL/min). Secreted volume and secretion rate had the strongest correlation with body surface area (BSA) (r = 0.54 and 0.59, respectively) and multiple regression defined BSA as the only significant predictor of secretory function. Each 1 m2 increase in BSA was associated with a 38 mL increase in secreted fluid volume.

Conclusions

In children, pancreatic secretory response to secretin, measured by MRI, depends on participant size, particularly BSA. Secreted volume <43 mL or a secretion rate <2.3 mL/min (5th percentile values) can be considered abnormal for children.

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Acknowledgements

Daniel B. Wallihan, MD for his contributions in developing the quantitative MRI technique.

Author information

Affiliations

  1. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    • Andrew T. Trout MD
  2. Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    • Andrew T. Trout MD
    • , Suraj D. Serai PhD
    •  & Qin Sun MPH
  3. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    • Lin Fei PhD
  4. Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    • Maisam Abu-El-Haija MD

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Guarantor of the article

Andrew T. Trout, MD.

Specific author contributions

ATT—study planning, study conduct, collecting data, interpreting data, and drafting manuscript. SDS—study planning, study conduct, and drafting manuscript. LF—study planning, interpreting data, and drafting manuscript. QS—interpreting data and drafting manuscript. MA-E-H—study planning, study conduct, collecting data, interpreting data, and drafting manuscript. Each author has approved the final draft of the manuscript as submitted

Financial support

This work was funded by a grant from the National Pancreas Foundation.

Potential competing interests

ATT has investigator initiated grants for unrelated studies from Toshiba America Medical Systems and Siemens Medical Solutions. ATT has received travel support from Philips Healthcare to attend an MRI users group meeting. ChiRhoClin Inc. provided secretin for this study. The remaining authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Andrew T. Trout MD.

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DOI

https://doi.org/10.1038/s41395-018-0190-9