Evaluation of pancreatic exocrine function by secretin-enhanced magnetic resonance cholangiopancreatography.

AIM: To assess the feasibility and usefulness of secretin-enhanced magnetic resonance cholangiopancreatography (S-MRCP) for evaluation of pancreatic exocrine function. METHODOLOGY: S-MRCP was performed in 20 patients with mild (n = 8) or severe (n = 12) chronic pancreatitis (according to the grade of exocrine pancreatic insufficiency indicated by the Lundh test) and in 10 volunteers without pancreatic disease. MRCP images were evaluated before and 10 minutes after the intravenous administration of 0.5 IU/kg secretin. The changes in pancreatic tissue T2 signal intensity and duodenal filling after the injection of secretin were determined by means of S-MRCP. The S-MRCP findings were then compared with those of the Lundh test. RESULTS: The pancreatic T2 signal intensity showed a significant elevation after secretin administration in the volunteers and in the patients with mild or severe chronic pancreatitis. This elevation was significantly lower in patients with mild and severe chronic pancreatitis than in the volunteers (66.85+/-15.77 and 24.45+/-5.85 vs. 200.0+/-45.07, respectively). After administration of secretin. the diameter of the duodenum was significantly increased in all three groups. This duodenal filling was significantly reduced in patients with mild or severe exocrine pancreatic insufficiency as compared with the volunteers (4.12+/-1.33 and 1.70+/-0.77 vs. 15.38+/-1.73, respectively). There was no significant difference in pancreatic T2 signal intensity changes or in duodenal filling in patients with mild or severe exocrine pancreatic insufficiency. There were significant correlations between the pancreatic T2 signal intensity changes and the duodenal filling and the results of the Lundh test (r = -0.616 and -0.78). CONCLUSION: These results demonstrate that the administration of secretin increases the T2 signal intensity of the pancreatic tissue and the diameter of the duodenum to different extents in normal subjects and in patients with chronic pancreatitis. This suggests that S-MRCP can provide information of value in the assessment of an exocrine pancreatic insufficiency.

[A simple method of cervical myelography by lumbar injection of Omnipaque]. / A nyaki myelographiák egyszerü módszere lumbalis úton beadott Omnipaque-kal.

The authors report on the experiences with cervical myelography performed in 94 cases in the past years at their Institute. On the basis of the results a simple and reliable procedure easy to perform with the lumbar administration of Omnipaque contrast material in lying position is described and recommended. Examinations performed by cervical puncture are justified only according to the authors' opinion if their method fails to be successful.

The part of MR cholangiography in biliary surgery.

The magnetic resonance cholangiography (MRC) is a new none invasive examination procedure which demonstrates well the extrahepatic ducts. The examination can reveal all the anatomical or pathological anomalies of the biliary tracts. The authors performed this examination on 12 patients between 1st December 1996 and 31st December 1996. In 4 patients there were no pathological changes. Common bile duct stone was found in 1 patient. Sclerosis of the Vater papilla in 1 case. Mirizzi syndrome in 1 case. Carcinoma of the common bile duct in 3 cases. In 2 cases inflammation of the head of the pancreas caused compression on the bile duct. The patients were all operated. The operative and the MRC diagnosis corresponded. Similar examination procedure has not yet been mentioned in Hungary.

[Urographic evaluation of Vx2 kidney carcinoma and control implantation in rabbits]. / Urographische Bewertung des Vx2-Nierenkarzinoms und der Kontroll-Implantation bei Kaninchen.

The development of Vx2 carcinoma induced in the kidney of rabbits was followed by urography. First the X-ray anatomy of the renal pelvis in the rabbit is described, pointing out the differences against the human pattern. Urography is easy to carry out and to evaluate, and it revealed some sign of the turnover in 75,6% of the cases in the third week and in 100% after 21 days. The radiological symptoms are described and classified. These symptoms are not specific but call attention to the progress of carcinoma.

[Enzymologic investigations of Vx2-carcinoma transplanted into the stomach of rabbits (author's transl)]. / Enzymologische Untersuchungen bei Kaninchen mit V x2-Magenkarzinom

Suspensions of V x2-carcinoma cells were inoculated into the stomach wall of rabbits. In 26 animals, changes of lactic acid hydrogenase (total activity and isoenzyme distribution) were followed from the transplantation day to complete development of a tumor. Findings were compared with mucosa specimen taken from different parts of the stomach. As compared with control animals (injection of physiological saline solution into the stomach wall), total enzyme activity was elevated and isoenzymes showed characteristic distribution in homogenisates from tumorous tissue. Mucosa covering the tumor did not reveal such alterations of enzyme activity. It can thus be concluded that V x2 carcinoma was limited to submucosal layers and did not invade the mucosa. This conclusion was confirmed by histologic examination.

[Experimental methods of creating V X 2 bone tumour in rabbits (author's transl)]. / Experimentelle Methode zur Erzeugung von V X 2-Knochentumoren bei Kaninchen

V X 2-carcinomas were induced in rabbit femurs by various methods. Inoculation near the periosteum after injury of the condylus medialis femoris was considered most successful. Results of 124 inoculations and 10 controls are demonstrated by angiograms, pharmakoangiograms and histologic photographs. Injury of periosteum and bone favors the taking and spreading of malignant growth.