Evaluation of change in flow of bile, pancreatic juice and lymph under secretion stimulation with non-contrast MR imaging using Time SLIP - Change in flow of bile, pancreatic juice and lymph under secretion stimulation with non-contrast MRI

Objective: In a previous study, we demonstrated that a quantitative evaluation of exocrine pancreatic function could be performed noninvasively using cine-dynamic magnetic resonance cholangiopancreatography (MRCP). The purpose of the present study was to elucidate the relationship between exocrine pancreatic function, as evaluated using cine-dynamic MRCP, and abdominal symptoms. Materials and Methods: Cine-dynamic MRCP was performed and an 18-item questionnaire on abdominal symptoms was administered to 103 patients with various types of abdominal symptoms. Excluding patients whose abdominal symptoms improved after they were prescribed drugs for those symptoms, 42 patients were eventually included in the study. Cine-dynamic MRCP evaluations were performed with the agreement of 2 radiologists. The relationship between exocrine pancreatic function, which was quantified as an exocrine pancreatic score, and the abdominal symptoms for the 18 questionnaire items was assessed. Results: Symptoms for 3 of the 18 abdominal symptom items were significantly associated with decreased exocrine pancreatic function, as measured by cine-dynamic MRCP: item 9, flatus smells worse than usual; item 13, stool quantity is large; and item 18, stools are soft. No significant correlation with exocrine pancreatic function measured by cine-dynamic MRCP was seen for the remaining 15 abdominal symptom items. Conclusion: The abdominal symptoms for the 3 items indicated in the results are symptoms that are more likely to appear as a result of decreased exocrine pancreatic function. If a patient complains of such symptoms, the possibility of decreased exocrine pancreatic function should be considered, and such function should be aggressively evaluated by cine-dynamic MRCP.