ESGAR和ESPR肠道MR成像推荐联合共识中肠道充盈规范在低BMI患者中的应用研究

Application of intestinal filling specifications of ESGAR and ESPR MR enterography recommendation in patients with low BMI

目的探讨欧洲胃肠和腹部放射学会(European Society of Gastrointestinal and Abdominal Radiology,ESGAR)和欧洲儿科放射学会(European Society of Paediatric Radiology,ESPR)肠道MRI推荐联合共识中肠道充盈在低体质量指数(body mass index,BMI)患者的可行性及技术要点。材料与方法回顾分析2017年11月1日至2018年12月31日期间因怀疑有小肠疾病而行小肠MRI检查的连续患者资料,肠道准备参照ESGAR及ESPR技术推荐执行,纳入无胃肠道手术的受试者进一步分析。记录受试者身高、体重及BMI值并分组(低BMI组、正常BMI组及高BMI组),记录摄入对比剂容积(正常摄取量组1200~1500 mL;低摄取量组1000~1200 mL)。由两位医师分别测量十二指肠、空肠(近端及远端)、回肠(近端及远端)直径,并按4分法评分。采用K-W检验比较不同BMI组之间各段肠道充盈评分差异有无统计学意义。进一步比较低BMI组中,低摄取量组与正常摄取量组各段肠道充盈评分差异有无统计学意义。结果受试者中,低BMI组均值为(16.8±1.2)kg/m2,正常BMI组为(21.3±1.6)kg/m2,高BMI组为(27.2±5.4)kg/m2。各BMI组两两间肠段充盈评分(总分及分段评分)无显著性差异(P>0.05);低BMI组中低摄取量组与正常摄取量组各肠段充盈评分无显著性差异(P>0.05)。结论不同BMI组应用ESGAR和ESPR技术推荐均可行,各肠道充盈评分差异无统计学意义。低BMI组中,对比剂低摄取量(1000~1200 mL)组与正常摄取量(1200~1500 mL)组的肠道充盈评分差异无统计学意义。

Objective:To investigate the feasibility and technical points of intestinal filling specifications of ESGAR(European Society of Gastrointestinal and Abdominal Radiology)and ESPR(European Society of Paediatric Radiology)recommendation of MR enterography in patients with low BMI.Materials and Methods:A retrospective study was performed between Nov.2017 and Dec.2018,the consecutive patients who are suspecting with small bowel disorders and without gastrointestinal surgery were included.The patients who did not follow the technical recommendations were exclude.Small bowel preparation was performed in accordance with the recommendation.The height,weight and body mass index(BMI)values of the patients were recorded and grouped(low BMI group,normal BMI group and high BMI group).The volume of the contrast agent was recorded(1200-1500 mL in the normal intake group and 1000-1200 mL in the low intake group).The diameters of the duodenum,jejunum(proximal and distal)and ileum(proximal and distal)were measured by two physicians and scored by 4 points.K-W test was used to compare the small bowel distension scores of different BMI groups.Further comparison of the low BMI group was performed.Results:For each BMI group,mean values were 16.8±1.2 kg/m2(low BMI group),21.3±1.6 kg/m2(normal BMI group),and 27.2±5.4 kg/m2(high BMI group).There was no significant difference in the distension scores(total score and segment score)between each BMI group(P>0.05).There was no significant difference in the distension scores between the low-intake group and the normal intake group(P>0.05)in low BMI patients.Conclusions:ESGAR and ESPR techniques arerecommended for different BMI groups,and there is no statistical difference in small bowel distention scores.In the low BMI group,there was no statistically significant difference in small bowel distention scores while taking the reduction of oral contrast dose(1000-1200 mL).