Diagnostics of pancreatic duct hypertension by the serotonin-stimulating magnetic resonance cholangiopancreatography (MRCP): A preliminary study.

Abstract

196 Background: Serotonin is a neurotransmitter which stimulates the pancreatic secretion. Pancreatic and periampullary tumors can cause the dilatation of the main pancreatic duct. Its partial stenosis can remain undiagnosed on conventional MRCP. Increasing secretion of pancreatic juice after stimulation by the serotonin can help to detect the location and length of a lesion. Methods: Eighteen patients with pancreatic cancer (n=14) and tumor of papilla Vateri (n=4) were included into the study. Median age was 64.9 years with range 45-84 years. Serotonin (0,01mg/kg) was administered perorally (n=2), intramuscularly (n=2), or intravenously with dilution (n=5) and without it (n=9). MRCP was performed before the drug application and 7 minutes later. Results: In cases where serotonin was administered perorally, intramuscularly or intravenously with dilution we did not receive any significant results. The positive results were obtained in 5 (55.6%) of 9 cases when MRCP was performed 7 minutes after intravenous administration of concentrated solution. The mean increase in width of the main pancreatic duct was 1.1 mm (range 0.9-1.9 mm). Conclusions: The method of serotonin stimulating MRCP can improve the diagnosis of pancreatic ductal hypertension. In these 5 cases, a presented technique allowed us to detect the size and localization of a lesion more precisely: tumor of a papilla (n=2), cancer of a pancreatic head (n=3) including one case with involvement of the pancreatic body. In cases of primary ductal dilatation more than 5 mm (n=3), we did not receive any positive results, so these patients were excluded from the study.