Baba Shigeaki, Sasaki Akira, Nakajima Jun, Obuchi Toru, Koeda Keisuke, Wakabayashi Go
Department of Surgery, Iwate Medical University School of Medicine, Morioka, Japan.
J Gastroenterol Hepatol. 2009 Aug;24(8):1401-6. doi: 10.1111/j.1440-1746.2009.05891.x.
The aim of the present study was to evaluate gastric motor function by magnetic resonance imaging (MRI) and investigate whether this examination is a useful tool for therapeutic efficacy or postoperative gastric motor function.
Twenty-five healthy volunteers and 10 gastric cancer patients with pylorus-preserving gastrectomy (PPG) underwent cine-MRI. Gastric volume was determined by 3D-volumetry. Gastric motility was quantified by calculating the gastric motility index (GMI).
The image acquisition and analysis were successfully carried out for all subjects. In healthy volunteers, mean frequency, amplitude, velocity of gastric peristaltic waves and GMI 30 min after the intake of jelly were 3/min, 8.8 mm, 2.2 mm/s and 19.6 mm2/s, respectively. Mean amplitude (8.8 vs 10.4 mm, P = 0.027), velocity (2.2 vs 2.6 mm/s, P < 0.001) of peristaltic waves, and GMI (19.6 vs 26.7 mm2/s, P < 0.001) significantly increased at 30 min after giving mosapride citrate (MS). Mean gastric volume after MS administration was significantly decreased; 0 min (317.3 vs 272.9 mL, P = 0.021), 45 min (263.4 vs 206.4 mL, P = 0.004) and 60 min (228.7 vs 165 mL, P = 0.001). PPG patients with postprandial symptoms were observed having antiperistalsis-like contraction waves and reflux of gastric contents from the pyloric region into the upper part of the stomach. Mean gastric volume in PPG patients with postprandial symptoms at 30 min after intake of jelly tended to be greater than in those without such symptoms.
The present study demonstrates that cine-MRI is a sensitive and non-invasive imaging technique for simultaneously measuring gastric motility and emptying.
本研究旨在通过磁共振成像(MRI)评估胃运动功能,并探讨该检查是否为评估治疗效果或术后胃运动功能的有用工具。
25名健康志愿者和10名接受保留幽门胃切除术(PPG)的胃癌患者接受了电影MRI检查。通过三维容积测量法测定胃容积。通过计算胃动力指数(GMI)对胃动力进行量化。
所有受试者均成功完成图像采集与分析。在健康志愿者中,摄入果冻后30分钟,胃蠕动波的平均频率、幅度、速度和GMI分别为3次/分钟、8.8毫米、2.2毫米/秒和19.6平方毫米/秒。给予枸橼酸莫沙必利(MS)后30分钟,蠕动波的平均幅度(8.8对10.4毫米,P = 0.027)、速度(2.2对2.6毫米/秒,P < 0.001)以及GMI(19.6对26.7平方毫米/秒,P < 0.001)均显著增加。给予MS后平均胃容积显著降低;0分钟时(317.3对272.9毫升,P = 0.021)、45分钟时(263.4对206.4毫升,P = 0.004)以及60分钟时(228.7对165毫升,P = 0.001)。观察到有餐后症状的PPG患者出现逆蠕动样收缩波以及胃内容物从幽门区域反流至胃上部。有餐后症状的PPG患者在摄入果冻后30分钟时的平均胃容积往往大于无此类症状的患者。
本研究表明,电影MRI是一种用于同时测量胃动力和排空的敏感且无创的成像技术。