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克罗恩病患者炎症性小肠病变中形态学扩张与病变内及病变前蠕动障碍之间的相关性——初步数据

Correlation between morphological expansion and impairment of intra- and prelesionary motility in inflammatory small bowel lesions in patients with Crohn's disease - preliminary data.

作者信息

Bickelhaupt Sebastian, Wurnig Moritz, Boss Andreas, Patak Michael A

机构信息

University Hospital Zürich, Department of Radiology, Rämistrasse 100, 8091 Zürich, Switzerland.

University Hospital Zürich, Department of Radiology, Rämistrasse 100, 8091 Zürich, Switzerland; Hirslanden Clinic, Radiology, Witellikerstrasse 40, 8032 Zürich, Switzerland.

出版信息

Eur J Radiol. 2014 Jul;83(7):1044-1050. doi: 10.1016/j.ejrad.2014.03.009. Epub 2014 Mar 22.

DOI:10.1016/j.ejrad.2014.03.009
PMID:24794863
Abstract

INTRODUCTION

The aim of this study is to investigate if alterations of intra- and prelesionary motility in inflamed small-bowel segments correlate with length, wall-thickness and prelesionary dilatation of inflammatory small bowel lesions in patients suffering from Crohn's disease assessed with MRI.

METHODS AND MATERIALS

This retrospective IRB approved study included 25 patients (12 males, 18-77y) with inflammatory lesions examined using (MRE) magnetic resonance imaging enterography. Cine MRE was performed using a coronal 2D steady-state free precession sequence (TR 2.9, TE 1.25) on a 1.5T MRI scanner. Small bowel motility was examined using a dedicated MR-motility assessment software (Motasso, Vers. 1.0, Sohard AG, Bern, Switzerland). Motility patterns (contraction frequency, relative occlusion rate and mean diameter) were assessed in correlation to wall thickness, length and prelesionary dilatation of the lesions. Statistical analysis was performed by calculation of the Pearson's-Correlation coefficient.

RESULTS

The length of the inflammatory segments, the wall thickening and prelesionary dilatation did not correlate with the frequency of the contractions (r=0.17, p=0.477; r=0.316, p=0.123; r=0.161, p=0.441) or the impairment of luminal occlusion (r=0.274, p=0.184; r=0.199, p=.0339; r=0.015, p=0.945) and only the prelesionary dilatation (r=0.410, p=0.042) correlated to the mean luminal diameter of the segment.

CONCLUSION

The degree of motility impairment within inflammatory small bowel lesions does not significantly correlate with the extent of the lesion but with the motility measured in prelesionary, non-affected segments, suggesting an interdependent functional aspect of inflammation even in morphologically non-affected small bowel segments.

摘要

引言

本研究的目的是调查炎症性小肠段内及病变前蠕动的改变是否与克罗恩病患者炎症性小肠病变的长度、肠壁厚度及病变前扩张程度相关,这些病变通过磁共振成像(MRI)进行评估。

方法与材料

这项经机构审查委员会(IRB)批准的回顾性研究纳入了25例(12例男性,年龄18 - 77岁)患有炎症性病变的患者,使用磁共振成像小肠造影(MRE)进行检查。在1.5T MRI扫描仪上,采用冠状面二维稳态自由进动序列(TR 2.9,TE 1.25)进行电影MRE检查。使用专用的磁共振运动评估软件(Motasso,版本1.0,Sohard AG,瑞士伯尔尼)检查小肠蠕动。评估蠕动模式(收缩频率、相对阻塞率和平均直径)与病变的肠壁厚度、长度及病变前扩张程度的相关性。通过计算皮尔逊相关系数进行统计分析。

结果

炎症段的长度、肠壁增厚及病变前扩张与收缩频率(r = 0.17,p = 0.477;r = 0.316,p = 0.123;r = 0.161,p = 0.441)或管腔阻塞受损情况(r = 0.274,p = 0.184;r = 0.199,p = 0.339;r = 0.015,p = 0.945)均无相关性,仅病变前扩张(r = 0.410,p = 0.042)与该段肠腔平均直径相关。

结论

炎症性小肠病变内的蠕动受损程度与病变范围无显著相关性,但与病变前未受影响段的蠕动相关,这表明即使在形态学上未受影响的小肠段,炎症也存在相互依存的功能方面。

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