| Zi Wang,Hao Tang,Jianjun Li,Qiuxia Wang,Yaqi Shen,Zhen Li,Sishu Yuan,Daoyu Hu. Cine magnetic resonance imaging for quantitative assessment of healthy volunteers and patients with organic small bowel disease. Oncol Transl Med, 2015, 1: 152-158. |
| 磁共振电影定量评估正常志愿者与器质性小肠疾病患者小肠运动功能的研究 |
| Cine magnetic resonance imaging for quantitative assessment of healthy volunteers and patients with organic small bowel disease |
| Received:June 11, 2015 Revised:July 30, 2015 |
| DOI：10.1007/s10330-015-0101-0 |
| 中文关键词: 小肠运动 ；磁共振电影；定量评估 |
| 英文关键词: small bowel; magnetic resonance (MR) cine; quantitative assessment |
| 基金项目:国家自然科学基金（81371524） |
| Author Name | Affiliation | E-mail | | Zi Wang | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, Hubei, China | wangzi2811@qq.com | | Hao Tang | Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, | wangzi2811@qq.com | | Jianjun Li | Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, | wangzi2811@qq.com | | Qiuxia Wang | Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, | wangzi2811@qq.com | | Yaqi Shen | Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, | wangzi2811@qq.com | | Zhen Li | Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, | wangzi2811@qq.com | | Sishu Yuan | Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, | wangzi2811@qq.com | | Daoyu Hu* | Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, | cjr.hudaoyu@vip.163.com |
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| 中文摘要: |
| 目的：运用MR电影定量参数比较正常志愿者与不同小肠器质性疾病患者之间的小肠运动差异，从而发现正常与不同情况下肠道功能受损情况的特征。
材料和方法：收集2012年12月至2014年2月间44名健康志愿者志愿者（男性20名，女性24名，平均年龄为36±13.01岁（20-61岁））以及临床怀疑小肠器质性疾病患者42 名（男性28名，女性14名，平均年龄44.14±18.31岁（15-72岁）），所有志愿者以及患者均签署了知情同意书。所有受试者在3.0T MR扫描前1小时内均匀饮入配置好的2.5%等渗甘露醇溶液1500ml。随后，进行MR电影扫描，扫描序列为时长为两分钟的冠状位2D-FIESTA-cine序列（自由呼吸状态）。我们将磁共振电影图像中标记的两段充盈良好的目标肠管的静止期肠腔肠管管径（Luminal Diameter，LD）、收缩周期（Contraction Period，CP）、收缩频率（Frequency，FC）以及幅度-肠腔管径比（Amplitude-Diameter Ratio，ADR）进行记录。
结果：通过将所绘制的患者组目标肠管的时间-肠腔管径曲线与正常组进行对比，两名医师一共确定了37段存在异常运动形式的肠管，并发现了5种不同的小肠病理蠕动形式：Ⅰ.连续型；Ⅱ.缓慢型；Ⅲ.宽大型；Ⅳ.紊乱性；Ⅴ.静止型。与正常组相比，5种不同异常形式的静止期肠腔管径均增大；在收缩频率方面，连续型（I型）(8.73±1.15/min）高于正常组，宽大型（III型）(0.67±0.29/min)均低于正常组，而缓慢型（II型）(3.19±0.43/min)与正常组(3.45±0.57/min)无差异；此外，除连续型(I型) (8.70±0.75/min)收缩周期与正常组相比无明显差异之外，其余四种异常收缩类型的收缩周期均高于正常组，对于幅度-肠腔管径比值（ADR）而言，异常运动中仅缓慢型（II型）（0.82±0.08）与正常组之间的差异不明显，对于收缩周期的比较中，缓慢型收缩与正常组相比无差异。
结论：我们可以运用MR电影图像对正常和异常的小肠运动情况进行有效的区分，同时，通过绘制目标肠管的时间-肠腔管径曲线以及对相关小肠运动定量参数的测定和分析，我们能够得到更佳精确的小肠运动信息。 |
| 英文摘要: |
| Objective: The aim of the study was to use dynamic magnetic resonance imaging (MRI) to compare quantitative parameters of small bowel motility between healthy volunteers and patients with small bowel diseases in order to investigate the characteristics of normal and impaired bowel peristalsis.
Methods: A total of 44 healthy volunteers (20 men, 24 women; mean age: 36 years; range: 20–61 years) and 42 patients (28 men, 14 women; mean age: 44 years; range: 15–72 years) with organic small bowel disease were recruited in our hospital (Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China) in this prospective study approved by the hospital institutional review board. Imaging was performed using a 3.0-T scanner 45 minutes after standardized oral administration of 1500 mL non-absorbable fluid (2.5% mannitol). A serial coronal scan was performed at selected planes for two minutes without breath-hold. Time-caliber curves were plotted at two well-distended small bowel loops in both healthy and patient groups regardless of location. Luminal diameter (LD), contraction period (CP), frequency of contraction (FC), and amplitude-diameter ratio (ADR) were measured based on the graph.
Results: The characteristics of abnormal peristaltic parameters were assessed in different patients and compared to normal curves from healthy volunteers. A total of 37 segments with abnormal motility were confirmed by two readers in consensus, based on curve patterns and the presence of a stationary phase. Compared to normal peristalsis in healthy volunteers, five different patterns of impaired peristalsis were identified: I, consecutive; II, slow; III, giant type; IV, uncoordinated; and V, akinetic. Dilated LDs were detected in all instances of abnormal peristalsis (P < 0.05). Increased frequency was found in type I [(8.73 ± 1.15) /min], while decreased frequency was detected in type III peristalsis [(0.67 ± 0.29) /min]. There were no significant differences in frequency between type II [(3.19 ± 0.43) /min] and normal peristalsis [(3.45 ± 0.57) /min]. Apart from type I [(8.70 ± 0.75) /min], increased FCs were found in all other abnormal patterns.
In type II peristalsis, the average ADR value was 0.82 ± 0.08, comparable to the ADR value in the healthy group (0.83 ± 0.13).
Conclusion: MR cine is an effective method for differentiating normal and abnormal small bowel peristalsis. Plotting time-caliber curves and measuring quantitative MR cine parameters such as LD, CP, FC, and ADR offers more precise information about small bowel motility. |
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