与胰腺酶流减少相关的症状：磁共振胰胆管成像评估。
Symptoms that are associated with decreased pancreatic enzyme flow: MRCP assessment.
机构信息
Department of Radiology, Kawasaki Medical School, Kurashiki, Japan.
Department of Radiology, Yamaguchi University, Ube, Japan.
出版信息
J Magn Reson Imaging. 2019 Aug;50(2):417-423. doi: 10.1002/jmri.26619. Epub 2019 Jan 13.
BACKGROUND
Pancreatic exocrine insufficiency is one of the causes of malabsorption syndrome. In many cases of malabsorption syndrome, pancreatic exocrine insufficiency can be treated with pancreatic enzyme replacement therapy. Therefore, it is important to detect pancreatic endocrine insufficiency as early and accurately as possible. Recent studies have shown that cine-dynamic MR cholangiopancreatography (MRCP) may be useful to evaluate pancreatic exocrine function PURPOSE: To identify abdominal symptoms that suggest decreased flow of pancreatic enzyme secretion for which cine-dynamic MRCP should be performed to diagnose pancreatic exocrine insufficiency.
STUDY TYPE
Prospective.
POPULATION
In all, 111 patients with various types of abdominal symptoms.
FIELD STRENGTH/SEQUENCE: 5 T or 3 T, MRCP with spatially selective inversion recovery pulse (cine-dynamic MRCP).
ASSESSMENT
Cine-dynamic MRCP was performed and an 18-question clinical questionnaire on abdominal symptoms was administered. The secretion grade derived from cine-dynamic MRCP was compared between those answering "yes" and "no" for all 18 items STATISTICAL TESTS: Univariate analysis and further analyzed using multiple regression analysis. The associations between the secretion grade and the items in the clinical questionnaire were analyzed by univariate analysis and further analyzed using multiple regression analysis.
RESULTS
The following three items showed significantly negative correlations with secretion grade: Q9, Does your rectal gas smell foul? (β = -0.44, P = 0.001); Q13, Is stool quantity large? (β = -0.41, P = 0.001); and Q18, Are your stools soft? (β = -0.53, P < 0.001). No significant correlations with exocrine pancreatic function measured by cine-dynamic MRCP were seen for the remaining 15 abdominal symptom items.
DATA CONCLUSION
Abdominal symptoms that suggest decreased flow of pancreatic enzyme secretion were foul rectal gas, large stool, and soft stool. Pancreatic exocrine insufficiency due to decreased pancreatic enzyme flow may be suspected in patients with these abdominal symptoms.
LEVEL OF EVIDENCE
1 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2019;50:417-423.
背景
胰腺外分泌功能不全是吸收不良综合征的原因之一。在许多吸收不良综合征病例中，胰腺外分泌功能不全可通过胰腺酶替代疗法治疗。因此，尽早且准确地检测胰腺内分泌功能不全非常重要。最近的研究表明，电影动态磁共振胰胆管成像（MRCP）可能有助于评估胰腺外分泌功能。目的：确定提示胰酶分泌减少的腹部症状，以便进行电影动态 MRCP 以诊断胰腺外分泌功能不全。
研究类型
前瞻性。
人群
共有 111 例各种类型腹部症状的患者。
磁场强度/序列：5T 或 3T，采用空间选择性反转恢复脉冲的 MRCP（电影动态 MRCP）。
评估
进行电影动态 MRCP，并对腹部症状进行 18 项临床问卷评估。将电影动态 MRCP 得出的分泌等级与所有 18 项问题的“是”和“否”答案进行比较。
统计检验
单变量分析，并进一步使用多元回归分析进行分析。使用单变量分析分析分泌等级与临床问卷项目之间的关系，并进一步使用多元回归分析进行分析。
结果
以下三个项目与分泌等级呈显著负相关：Q9，您的直肠排气是否有臭味？（β=-0.44，P=0.001）；Q13，粪便量是否大？（β=-0.41，P=0.001）；和 Q18，您的粪便是否软？（β=-0.53，P<0.001）。对于电影动态 MRCP 测量的胰腺外分泌功能，其余 15 个腹部症状项目与胰腺外分泌功能没有显著相关性。
数据结论
提示胰酶分泌减少的腹部症状是恶臭的直肠排气、大量粪便和软便。怀疑有这些腹部症状的患者可能存在由于胰酶流减少引起的胰腺外分泌功能不全。
证据水平
1 技术功效阶段：3 J. Magn. Reson. Imaging 2019；50：417-423。
Zotero 插件