Centre for Medical Imaging, University College London, London, UK.
Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Neurogastroenterol Motil. 2017 Sep;29(9). doi: 10.1111/nmo.13090. Epub 2017 May 31.
The clinical use of Magnetic Resonance Imaging (MRI) for investigating gastric motor function in dyspepsia is limited, largely due to protocol complexity, cost and limited availability. In this study, we explore the feasibility of a sub 60-minute protocol using a water challenge to assess gastric emptying, motility and accommodation in a cohort of Ehlers-Danlos Syndrome-Hypermobility type (EDS-HT) patients presenting with dyspepsia.
Nine EDS-HT patients (mean age 33, range: 26-50 all female) with a history of dyspepsia were recruited together with nine-matched controls. Subjects fasted for 6 hours prior to MRI. A baseline anatomical and motility scan was performed after which the subjects ingested 300 mL water. The anatomical and motility scans were then repeated every 10 minutes to a total of 60 minutes. Gastric emptying time, motility, and accommodation were calculated based on the observations of two observers for each EDS-HT subject and compared to their matched control using paired statistics.
Median motility increase following the water challenge was lower in EDS-HT subjects (11%, range: 0%-22%) compared to controls (22%, range: 13%-56%), P=.03. Median gastric emptying time was non-significantly decreased in EDS-HT subjects (12.5 minutes, range: 6-27) compared to controls (20 minutes, range: 7-30), P=.15. Accommodation was non-significantly reduced in EDS-HT subjects (56% increase, range: 32%-78%) compared to healthy controls (67% increase, range: 52%-78%), P=.19.
CONCLUSIONS & INFERENCES: This study demonstrates the feasibility of a water challenge MRI protocol to evaluate gastric physiology in the clinical setting. Motility differences between EDS-HT and controls are worthy of further investigation.
磁共振成像（MRI）在消化不良患者胃动力研究中的临床应用受到限制，主要是因为方案复杂、成本高以及可用性有限。在这项研究中，我们探索了使用水负荷挑战在以消化不良为表现的埃勒斯-当洛斯综合征-高活动度型（EDS-HT）患者中评估胃排空、动力和顺应性的亚 60 分钟方案的可行性。
招募了 9 名 EDS-HT 患者（平均年龄 33 岁，范围：26-50 岁，均为女性）和 9 名匹配对照，他们均有消化不良病史。在 MRI 前，患者禁食 6 小时。在进行基线解剖和动力扫描后，患者饮用 300 毫升水。然后每隔 10 分钟重复进行解剖和动力扫描，总共 60 分钟。基于两名观察者对每个 EDS-HT 患者的观察，计算胃排空时间、动力和顺应性，并使用配对统计方法将其与匹配对照进行比较。
水负荷挑战后 EDS-HT 患者的平均动力增加幅度（11%，范围：0%-22%）低于对照组（22%，范围：13%-56%），P=.03。与对照组相比，EDS-HT 患者的胃排空时间（中位数：12.5 分钟，范围：6-27）无显著缩短（中位数：20 分钟，范围：7-30），P=.15。与对照组相比，EDS-HT 患者的顺应性（中位数：56%，范围：32%-78%）无显著降低（中位数：67%，范围：52%-78%），P=.19。
本研究证明了水负荷 MRI 方案在临床环境中评估胃生理的可行性。EDS-HT 患者和对照组之间的动力差异值得进一步研究。
