Objectives <p>Magnetic resonance imaging (MRI) with secretin stimulation allows non-invasive assessment of pancreatic secretion in vivo. Software (PFTquant) can facilitate quantification of secretory response. Our objective was to quantify secretory response for a clinical sample of pediatric patients and compare quantitative to qualitative assessment.</p> Methods <p>Two hundred one examinations of 169 patients (&lt; 21 years of age) were processed using PFTquant and manually refined by human observers. Fluid volumes were characterized as normal or abnormal based on 5th percentile values by body surface area (BSA) and age and were compared to qualitative assessment of secretory response.</p> Results <p>The mean patient age was 12.1 ± 4.9 (0–20) years and 106 (52.7%) were female. The most common diagnoses were acute recurrent (<i>n</i> = 54, 26.9%), chronic (<i>n</i> = 53, 26.4%), and acute (<i>n</i> = 29, 14.4%) pancreatitis. Based on human-refined segmentation, secretory response was abnormal in 70 (34.8%; by BSA) and 62 (30.8%; by age) patients, including 48.3% (14/29) of patients with acute pancreatitis. Clinical reports characterized secretory response as qualitatively abnormal in 26/201 (12.9%) examinations. Compared to quantitative analysis, qualitative assessment was falsely positive in 12 cases and falsely negative in 50 (BSA) or 55 (age) cases.</p> Conclusion <p>In a clinical sample of pediatric and young adult patients, abnormal pancreatic secretory response was present in 30.8 to 34.8% of patients and was most common in patients with acute pancreatitis. Quantiative assessment identifies more patients with abnormal secretory response than qualitative assessment.</p>