How radiologist can use Chirhostim

Abdominal Radiologists


MRCP has been used for non-invasive evaluation of the pancreas for several decades, providing excellent visualization of the pancreatic and biliary ductal systems. However, despite being the most accurate tool for pancreas imaging, the limiting nature of static imaging affects the providers’ assessment of pancreatic response to stimulation and real-time pancreatic function.


SMRCP allows physicians to assess the endocrine function of the pancreas in real time. It is a valuable tool for imaging the pancreas.

Due to the dynamic nature of S-MRCP imaging, the visualization of the pancreas is transformed from a static image (MRCP) to high temporal resolution images, which in turn is useful for getting a complete picture of the pancreatic response in physiologic condition and obtaining functional information.

There are clear benefits to the SMRCP technique, such as

Advanced Visualization

Secretin-enhanced MRCP (S-MRCP) increases visualization of ductal anatomy and provides insight into pancreatic function, which allows radiologists to offer additional insight for a range of pancreatic-related conditions.

Non-invasive Identification of ABPJ

While both ERCP and MRCP can identify anomalous pancreaticobiliary junction (ABPJ), MRCP has the advantage of being noninvasive. S-MRCP has the ability to evaluate APBJ in enough detail to demonstrate reflux of fluid signal into the common bile duct after secretin administration.

Sensitivity and Specificity

A recent meta-analysis demonstrated sensitivity and specificity of up to 86% and 97% respectively, which were significantly better than those of standard MRCP (52% and 97%, respectively).

Additionally, S-MRCP has been shown to have a sensitivity of 85.7% and specificity of 68% for diagnosing reflux into the common bile duct (Swensson, Zaheer, Conwell, Sandrasegaran, Manfredi, Tirkes, 2021).


Characterizing Severity of CP

In the early phase of inflammation associated with CP, pancreatic duct side branches may become enlarged and rounded, which allows for visualization by ERCP. Currently, the standard tool for characterization of severity is a modified version of the Cambridge criteria developed for ERCP.
The ability of secretin to induce fluid signal in the pancreatic ducts may increase conspicuity of these side branches, improving visualization compared to standard MRCP.


Dynamic Evaluation of Pancreaticobiliary Tree

Increase in bicarbonate and pancreatic fluid secretion by the exocrine cells, providing dynamic evaluation of pancreatic exocrine volume reserve that is not possible using standard MRCP.

Early Detection of Pancreatic Cancer

Early detection using advanced imaging techniques including SMRCP, may help plan a successful treatment and offer a better prognosis.

Fast Acting

Secretin is short-acting, relaxing the sphincter of Oddi and opening pancreatic duct orifices.
Data from ERCP studies demonstrate increased pancreatic duct pressure within 1 minute and near complete relaxation within 5 minutes. S-MRCP has been shown to have better diagnostic performance in identifying pancreas divisum as secretin-induced increased fluid excretion through the minor papilla may accentuate fluid signal in an otherwise small dorsal duct.