磁共振电影成像在功能性消化不良疾病评估中的应用

Application of MR-cine in evaluation on functional dyspepsia

目的:探讨磁共振(MR)电影(MR-cine)成像技术定量评估功能性消化不良患者十二指肠蠕动功能的价值。方法:根据功能性胃肠疾病(FGIDs)的罗马Ⅲ诊断标准筛选出功能性消化不良患者25例(病例组)及临床已筛查出的健康志愿者25名(正常对照组),禁食8h后取仰卧位。采用西门子1.5T磁共振扫描仪在憋气状态下对十二指肠降段进行冠状位、轴位及斜冠状位的MR-cine序列的扫描。采集口服600mL等渗甘露醇溶液(浓度2.5%)后5和15min的图像并传送至MR AW4.4工作站。通过记录十二指肠的蠕动波次数、测量并计算十二指肠收缩幅度(PDC)以反映功能性消化不良患者十二指肠蠕动情况。结果:饮用甘露醇后,经斜冠状位扫描,所有受试者可清晰显示十二指肠降段的解剖结构及蠕动情况。饮用甘露醇5和15min后病例组患者平均蠕动波次数低于正常对照组。5min时病例组患者十二指肠降段收缩幅度明显低于正常对照组(P<0.01);饮用甘露醇15min后正常对照组PDC明显低于5min时(P<0.05);但病例组与正常对照组受试者在饮用甘露醇15min后的PDC比较差异无统计学意义(P>0.05)。结论:MR-cine成像技术可初步定量评估功能性消化不良疾病的十二指肠蠕动功能,可应用这种无创的MR检查技术对诊断FGIDs进行进一步研究。

Objective： To explore the value of MR-cine for assessment of the duodenum peristalsis in the patients with functional dyspepsia. Methods： 25 patients with functional dyspepsia were selected according to the diagnostic criteria of Rome Ⅲ of functional gastrointestinal disorders （FGIDs） as case group and 25 cases of healthy volunteers who had been screened out in clinic were used as normal control group. After fasting for 8 h, supine position was performed. 1.5TGEHDxMR was used to scan the coronal, axial and oblique coronal fast steady state precession （FIESTA） sequence of gastric and duodenal descending part. The images of 5 and 15 min after drinking 600 mL mannitol solution （concentration 2.5 ~） were collected and sent to MR AW4. 4 workstation. The duodenal motility in the patients with functional dyspepsia was measured by recording the times of duodenum and measuring and calculating the percentage occlusion of duodenum contractions （PDC）. Results： After drinking mannitol, the oblique coronal scan of all subjects clearly displayed the anatomical structure and peristaltic wave of descending part of duodenum. After drinking 5 and 15 min of mannitol, the peristaltic wave frequencies in case group were lower than those in normal control group. The descending duodenum PDC of the patients in case group was significantly lower than that in normal control group （P〈0.01） 5 min after drinking. The PDC in normal control group 15 rain after drinking was lower than 5 rain （P〈0.05） the duodenal PDC 15 rain after drinking of mannitol had no statistical difference between case group and normal control group （P〉0.05）. Conclusion： MR-cine can evaluate preliminarly the duodenum peristalsis of the patients with functional dyspepsia. The diagnosis of FGIDs can be further studied by using the noninvasive MR-cine examination technique.