Department of Radiology, University Hospital Zürich, Zürich, Switzerland.
Clin Radiol. 2013 Dec;68(12):1247-53. doi: 10.1016/j.crad.2013.06.024. Epub 2013 Aug 21.
To evaluate the influence of locally active Crohn's disease on systemic small-bowel motility in patients with chronic Crohn's disease compared to healthy individuals.
Fifteen healthy individuals (11 men, four women; mean age 37 years) and 20 patients with histopathologically proven active (n = 15; 10 women, 5 men; mean age 45 years) or chronic (n = 5; four women, one man; mean age 48 years) Crohn's disease were included in this institutional review board-approved, retrospective study. Magnetic resonance imaging (MRI; 1.5 T) was performed after standardized preparation. Two-dimensional (2D) cine sequences for motility acquisition were performed in apnoea (27 s). Motility assessment was performed using dedicated software in three randomly chosen areas of the small-bowel outside known Crohn's disease-affected hotspots. The main quantitative characteristics (frequency, amplitude, occlusion rate) were compared using Student's t-test and one-way analysis of variance (ANOVA).
Three randomly chosen segments were analysed in each participant. Patients with active Crohn's disease had significantly (p < 0.05) reduced contraction frequencies (active Crohn's disease: 2.86/min; chronic: 4.14/min; healthy: 4.53/min) and luminal occlusion rates (active: 0.43; chronic: 0.70; healthy: 0.73) compared to healthy individuals and patients with chronic Crohn's disease. Contraction amplitudes were significantly reduced during active Crohn's disease (6.71 mm) compared to healthy participants (10.14 mm), but this only reached borderline significance in comparison to chronic Crohn's disease (8.87 mm). Mean bowel lumen diameter was significantly (p = 0.04) higher in patients with active Crohn's disease (16.91 mm) compared to healthy participants (14.79 mm) but not in comparison to patients with chronic Crohn's disease (13.68).
The findings of the present study suggest that local inflammatory activity of small-bowel segments in patients with active Crohn's disease alters small-bowel motility in distant, non-affected segments. The motility patterns revealed reduced contraction-wave frequencies, amplitudes, and decreased luminal occlusion rates. Thus evaluation of these characteristics potentially helps to differentiate between chronic and active Crohn's disease.
评估与健康个体相比，局部活动性克罗恩病对慢性克罗恩病患者全身小肠动力的影响。
本研究为机构审查委员会批准的回顾性研究，共纳入 15 名健康个体（11 名男性，4 名女性；平均年龄 37 岁）和 20 名经组织病理学证实为活动性（n=15；10 名女性，5 名男性；平均年龄 45 岁）或慢性（n=5；4 名女性，1 名男性；平均年龄 48 岁）克罗恩病患者。所有患者均接受了磁共振成像（MRI；1.5T）检查。在标准准备后进行二维（2D）电影序列以获取动力。在呼吸暂停（27s）时进行小肠动力评估，使用专用软件在三个随机选择的小肠区域（已知克罗恩病病变热点以外）进行。使用学生 t 检验和单向方差分析（ANOVA）比较主要定量特征（频率、幅度、闭塞率）。
每位参与者均分析了 3 个随机选择的节段。活动性克罗恩病患者的收缩频率（活动性克罗恩病：2.86/min；慢性：4.14/min；健康：4.53/min）和管腔闭塞率（活动性：0.43；慢性：0.70；健康：0.73）显著降低（p<0.05），与健康个体和慢性克罗恩病患者相比。与健康参与者（10.14mm）相比，活动性克罗恩病期间的收缩幅度（6.71mm）显著降低，但与慢性克罗恩病相比，这仅达到边缘显著（8.87mm）。与健康参与者（14.79mm）相比，活动性克罗恩病患者的平均肠腔直径（16.91mm）显著升高（p=0.04），但与慢性克罗恩病患者相比，肠腔直径没有升高（13.68mm）。
本研究结果表明，活动性克罗恩病患者小肠节段的局部炎症活动改变了远处非病变节段的小肠动力。动力模式显示收缩波频率、幅度降低，管腔闭塞率降低。因此，评估这些特征有助于区分慢性和活动性克罗恩病。
