分泌素(RG1068)增加的敏感性检测磁共振胰胆管造影导管异常的胰腺炎患者。
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谢尔曼年代,弗里曼ML, Tarnasky公关,Wilcox厘米,Kulkarni,爱森,雅各比D, Kozarek RA
分泌素(RG1068)增加的敏感性检测磁共振胰胆管造影导管异常的胰腺炎患者。
胃肠病学。2014年9月,147 (3):646 - 654. - e2。doi: 10.1053 / j.gastro.2014.05.035。Epub 2014年6月4。
- PubMed ID
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24906040 (在PubMed]
- 文摘
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背景与目的:管理胰管的分泌素提高了非侵入性成像和磁共振胰胆管造影(MRCP检查)。我们进行了一个大型的前瞻性研究调查是否合成人体分泌素(RG1068)刺激MRCP检查检测胰管异常水平较高的敏感性比MRCP检查。方法:我们进行了三期,多中心,baseline-controlled急性或急性复发性胰腺炎患者的研究是将内镜逆行胰胆管造影(ERCP)在3月26日,2008年和2009年10月28日。病人接受了一个基线MRCP检查,立即紧随其后RG1068和重复MRCP检查,然后进行ERCP在30天内;他们为30天随访。MRCP检查,内镜逆行胰胆管造影图像被3放射科医生和2英国读中央,分别都是独立和失明;胰管异常进行了评估。MRCP检查的准确性是评价使用内镜逆行胰胆管造影作为标准。结果:总体而言,258名患者参与研究;251 MRCP检查图像集进行了评估,和236例可评价的内镜逆行胰胆管造影。 Pancreatic duct abnormalities were observed in 60.2% of ERCP images. All radiologists identified duct abnormalities in RG1068-cine MRCP image sets with significantly higher levels of sensitivity (P < .0001) than in images from MRCP, with minimal loss of specificity. Adverse events were reported in 38.0% of patients after MRCP and 68.1% after ERCP. Of the 55 patients who experienced a serious adverse event, 3 (1.2%) and 52 (20.5%) of the events were reported to be temporally associated with MRCP and ERCP, respectively. The adverse events most frequently considered related to RG1068 were nausea, abdominal pain, and flushing; most were mild. CONCLUSIONS: Compared with images from MRCP, those from RG1068-stimulated MRCP are improved in many aspects and could aid in diagnosis and clinical decision making for patients with acute, acute recurrent, or chronic pancreatitis. RG1068-enhanced MRCP might also better identify patients in need of therapeutic ERCP (ClinicalTrials.gov, Number: NCT00660335).
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