Månsson Sven, Ekberg Olle, Ohlsson Bodil
Medical Radiation Physics, Department of Translational Medicine, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden.
Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital, Malmö 20502, Sweden.
World J Gastroenterol. 2020 Sep 28;26(36):5484-5497. doi: 10.3748/wjg.v26.i36.5484.
Recently, a technique has been developed to use magnetic resonance enterography (MRE) for the evaluation of small bowel motility. The hypothesis was that assessment of the motility index (MI) should reflect differences in motility between clinical conditions.
To aim of the present observational, cross-sectional study was to evaluate the use of the MI in daily clinical practice.
All consecutive patients aged 18-70 years who were referred for MRE at the Department of Radiology during a 2-year period were asked to participate. Healthy volunteers were included as controls. MRE was prepared and conducted in accordance with clinical routines. On the day of examination, all the participants had to complete the visual analog scale for irritable bowel syndrome (IBS) and IBS-symptom severity scale. Maps of MI were calculated from dynamic MR images. ANOVA was used to evaluate differences in MI between groups, classified as healthy, Crohn's disease, ulcerative colitis, IBS, other assorted disorders and dysmotility. Logistic and linear regression were applied to the MI values. All medical records were scrutinized for medical history.
In all, 224 examinations were included (inclusion prevalence 76.3%), with 22 controls and 202 patients. There was a significant difference in the MI of the jejunum ( 0.021) and terminal ileum ( 0.007) between the different groups. The MI was inversely associated with the mural thickness of the terminal ileum in men ( 0.001) and women ( 0.063) after adjustments, and tended to be lower in men than in women ( 0.056). Subjectively observed reduction of motility on MRI was accomplished by reduced MI of terminal ileum in men ( 0.001) and women ( 0.030). In women, diarrhea was inversely associated with the MI of the jejunum ( 0.029), and constipation was positively associated with the MI of the terminal ileum ( 0.039).
Although MIs differ across diseases, a lower MI of the terminal ileum is mainly associated with male sex and an increased mural thickness. Symptoms are weakly associated with the MI.
最近，已开发出一种利用磁共振小肠造影（MRE）评估小肠动力的技术。其假设是，对动力指数（MI）的评估应能反映不同临床状况下动力的差异。
本观察性横断面研究的目的是评估MI在日常临床实践中的应用。
邀请了在两年期间转诊至放射科接受MRE检查的所有18至70岁连续患者参与研究。纳入健康志愿者作为对照。MRE按照临床常规进行准备和实施。在检查当天，所有参与者都必须完成肠易激综合征（IBS）视觉模拟量表和IBS症状严重程度量表。从动态磁共振图像计算MI图。采用方差分析评估健康、克罗恩病、溃疡性结肠炎、IBS、其他各种疾病和动力障碍等组间MI的差异。对MI值应用逻辑回归和线性回归。仔细审查所有病历以了解病史。
总共纳入了224例检查（纳入患病率76.3%），其中22例对照和202例患者。不同组之间空肠（0.021）和回肠末端（0.007）的MI存在显著差异。调整后，男性（0.001）和女性（0.063）的MI与回肠末端壁厚度呈负相关，且男性的MI往往低于女性（0.056）。在MRI上主观观察到的动力降低表现为男性（0.001）和女性（0.030）回肠末端MI降低。在女性中，腹泻与空肠MI呈负相关（0.029），便秘与回肠末端MI呈正相关（0.039）。
尽管不同疾病的MI有所不同，但回肠末端较低的MI主要与男性性别和壁厚度增加有关。症状与MI的相关性较弱。
