三维超声胃重建成像评价健康人近端胃适应性功能

3DUS imaging in the evaluation of gastric accommodation in healthy subjects

目的采用三维超声（3DUS）胃重建结合灌注法液体营养餐负荷试验（P-NLT）评价健康志愿者（HS）近端胃适应性功能,以及P-NLT的可行性和可靠性。方法 HS 10例,分别采用3DUS和2DUS结合P-NLT（经鼻胃管,50 mL/min,0.75 kcal/mL）进行近端胃容积（PGV）、近端胃面积（PGA）成像及测量,P-NLT过程中采用VAS视觉评分（0~10）进行饱感评价,并记录不同饱感时的灌注量及时间。将3DUS的测量值与2DUS的相应参数比较。结果 2次P-NLT的阈值灌注量（TV）和最大灌注量（MV）均无显著性差异。3DUS测量的阈值PGV与TV（P〈0.05）、最大饱感时的最大PGV（P〈0.01）和最大PGA（P〈0.05）与MV均有显著相关性。3DUS测得的阈值PGA（P〈0.01）、最大PGV（P〈0.05）和最大PGA（P〈0.01）与相应2DUS测量参数比较有显著差异,但是最大饱感时采用3DUS测量的MV、PGA和PGV的拟合曲线与2DUS相应测量值的拟合曲线基本平行。结论 3DUS胃重建成像测量的近端胃变化能更准确更可靠地评价近端胃的适应性;P-NLT是一种有效评价近端胃适应性的方法。

Objective To evaluate gastric accommodation using 3D ultrasound imaging and perfusion nutrient load test（P-NLT） by means of gastric volumes calculation and to verify validation of P-NLT in evaluation of gastric accommodation in healthy subjects.Methods Ten healthy subjects received P-NLT through a nasal-gastric tube with a constant rate of 50 mL/min（0.75 kcal/mL）.Meanwhile 3DUS and 2DUS were used for imaging of PGV and PGA in different day,respectively.During the perfusion,visual analogue scale（VAS,0~10） was used to evaluate satiety.The nutrient volume in different satiety scale and time consume was recorded during P-NLT.Then the measure values in 3DUS were compared with corresponding parameters in 2DUS.Results No difference was found in the amount of nutrient liquid at minimal satiety and maximal satiety between the first and the second P-NLT study.PGV（P0.01） and PGA（P0.05） at maximal satiety measured by 3DUS were both significantly correlated with MV.Furthermore,PGV at minimal satiety measured by 3DUS（P0.05） was significantly correlated with TV.Significant differences were found in PGV（P0.05） and PGA（P0.01） at maximal satiety between 3DUS and 2DUS,and there was significant difference in PGA（P0.01）at minimal satiety in two methods,too.But thecurve estimated between MV and PGA or PGV at maximal satiety used by 2DUS was parallel with that in 3DUS.Conclusion 3DUS is superior to 2DUS for its accuracy and precision in volume estimation and more available for proximal gastric accommodation.P-NLT is a feasible and reliable method in evaluation of proximal gastric accommodation.