Secretin-Enhanced MRCP: How and Why- AJR Expert Panel Narrative Review

AJR Am J Roentgenol. 2021 May;216(5):1139-1149. doi: 10.2214/AJR.20.24857. Epub 2021 Mar 11.


Secretin-enhanced MRCP (S-MRCP) has advantages over standard MRCP for imaging of the pancreaticobiliary tree. Through the use of secretin to induce fluid production from the pancreas and leveraging of fluid-sensitive MRCP sequences, S-MRCP facilitates visualization of ductal anatomy, and the findings provide insight into pancreatic function, allowing radiologists to provide additional insight into a range of pancreatic conditions. This narrative review provides detailed information on the practical implementation of S-MRCP, including patient preparation, logistics of secretin administration, and dynamic secretin-enhanced MRCP acquisition. Also discussed are radiologists' interpretation and reporting of S-MRCP examinations, including assessments of dynamic compliance of the main pancreatic duct and of duodenal fluid volume. Established indications for S-MRCP include pancreas divisum, anomalous pancreaticobiliary junction, Santorinicele, Wirsungocele, chronic pancreatitis, main pancreatic duct stenosis, and assessment of complex postoperative anatomy. Equivocal or controversial indications are also described along with an approach to such indications. These indications include acute and recurrent acute pancreatitis, pancreatic exocrine function, sphincter of Oddi dysfunction, and pancreatic neoplasms.

Keywords: MRCP; MRI; pancreas; secretin.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Cholangiopancreatography, Magnetic Resonance / methods*
  • Expert Testimony
  • Humans
  • Image Enhancement / methods*
  • Pancreas / diagnostic imaging
  • Pancreatic Diseases / diagnostic imaging*
  • Periodicals as Topic
  • Secretin / administration & dosage
  • Secretin / pharmacology*


  • Secretin