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基于 MRI 的绞窄性小肠梗阻和肠系膜静脉闭塞所致肠系膜缺血的评价:使用兔的实验研究。

MR Imaging-based Evaluation of Mesenteric Ischemia Caused by Strangulated Small Bowel Obstruction and Mesenteric Venous Occlusion: An Experimental Study Using Rabbits.

机构信息

Department of Radiology, Shiga University of Medical Science.

Division of Molecular and Diagnostic Pathology, Shiga University of Medical Science.

出版信息

Magn Reson Med Sci. 2020 May 1;19(2):125-134. doi: 10.2463/mrms.mp.2019-0010. Epub 2019 May 7.

Abstract

PURPOSE

This study assessed the MRI findings of strangulated small bowel obstruction (SBO) and mesenteric venous occlusion (MVO) in a rabbit model using 3T MRI.

MATERIALS AND METHODS

Twenty rabbits were included in this study. The strangulated SBO and MVO models were generated via surgical procedures in nine rabbits, and sham surgery was performed in two rabbits. The success of generating the models was confirmed via angiographic, macroscopic, and microscopic findings after the surgical procedure. MRI was performed before and 30 min after inducing mesenteric ischemia. T-weighted images (TWIs), T-weighted images (TWIs), and fat-suppressed TWIs (FS-TWIs) were obtained using the BLADE technique, and fat-suppressed TWIs (FS-TWIs) were obtained. The signal intensities of the affected bowel before and after the surgical procedures were visually categorized as high, iso, and low intense compared with the findings for the normal bowel wall on all sequences. Bowel wall thickness was measured, and the signal intensity ratio (SI ratio) was calculated using the signal intensities of the bowel wall and psoas muscle.

RESULTS

Angiographic, macroscopic, and microscopic findings confirmed that all surgical procedures were successful. The ischemic bowel wall was thicker than the normal bowel. The bowel wall was thicker in the MVO model (3.17 ± 0.55 mm) than in the strangulated SBO model (2.26 ± 0.46 mm). The signal intensity and SI ratio of the bowel wall were significantly higher after the procedure than before the procedure on all sequences in both models. The mesentery adjacent to the ischemic bowel loop exhibited a high signal intensity in all animals on FS-TWIs.

CONCLUSION

Non-contrast MRI can be used to evaluate mesenteric ischemia caused by strangulated SBO and MVO. FS-TWIs represented the best modality for depicting the high signal intensity in the bowel wall and mesentery caused by ischemia.

摘要

目的

本研究旨在使用 3T MRI 评估兔模型中绞窄性小肠梗阻(SBO)和肠系膜静脉闭塞(MVO)的 MRI 表现。

材料与方法

本研究纳入 20 只兔子。通过手术在 9 只兔子中建立绞窄性 SBO 和 MVO 模型,在 2 只兔子中进行假手术。通过手术完成后的血管造影、大体和显微镜检查结果来确认模型的建立是否成功。在诱导肠系膜缺血前后 30 分钟进行 MRI 检查。使用 BLADE 技术获取 T1 加权图像(T1WI)、T2 加权图像(T2WI)和脂肪抑制 T2 加权图像(FS-T2WI),并获取脂肪抑制 T2 加权图像(FS-T2WI)。与所有序列中正常肠壁的表现相比,术前和术后受影响肠段的信号强度通过视觉分类为高、等、低强度。测量肠壁厚度,并使用肠壁和腰大肌的信号强度计算信号强度比(SI 比)。

结果

血管造影、大体和显微镜检查结果证实所有手术均成功。缺血肠壁比正常肠壁厚。MVO 模型中肠壁较厚(3.17±0.55mm),而绞窄性 SBO 模型中肠壁较薄(2.26±0.46mm)。在两个模型中,在所有序列上,术后肠壁的信号强度和 SI 比均明显高于术前。在所有动物中,FS-T2WI 上紧邻缺血肠袢的肠系膜显示高信号。

结论

非对比 MRI 可用于评估绞窄性 SBO 和 MVO 引起的肠系膜缺血。FS-T2WI 是显示缺血引起的肠壁和肠系膜高信号的最佳方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7199/7232033/9bdca1ed53d9/mrms-19-125-g1.jpg

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