Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam Gastroenterology & Metabolism, Amsterdam, The Netherlands.
Eur Radiol Exp. 2021 Feb 10;5(1):8. doi: 10.1186/s41747-021-00205-5.
Colonic manometry is the current reference standard for assessing colonic neuromuscular function in children with intractable functional constipation (FC). Recently, cine magnetic resonance imaging (cine-MRI) has been proposed as a non-invasive alternative. We compared colonic motility patterns on cine-MRI with those obtained by manometry in children, by stimulating high-amplitude propagating contractions (HAPCs) with bisacodyl under manometric control while simultaneously acquiring cine-MRI.
After Institutional Review Board approval, adolescents with FC scheduled to undergo colonic manometry were included. A water-perfused 8-lumen catheter was used for colonic manometry recordings. After an intraluminal bisacodyl infusion, cine-MRI sequences of the descending colon were acquired for about 30 min simultaneously with colonic manometry. Manometry recordings were analysed for HAPCs. MRI images were processed with spatiotemporal motility MRI techniques. The anonymised motility results of both techniques were visually compared for the identification of HAPCs in the descending colon.
Data regarding six patients (three males) were analysed (median age 14 years, range 12-17). After bisacodyl infusion, three patients showed a total of eleven HAPCs with colonic manometry. Corresponding cine-MRI recorded high colonic activity during two of these HAPCs, minimal activity during seven HAPCs, while two HAPCs were not recorded. In two of three patients with absent HAPCs on manometry, colonic activity was recorded with cine-MRI.
Simultaneous acquisition of colonic cine-MRI and manometry in children with FC is feasible. Their motility results did not completely overlap in the identification of HAPCs. Research is needed to unravel the role of cine-MRI in this setting.
结肠测压是评估难治性功能性便秘（FC）儿童结肠神经肌肉功能的当前参考标准。最近，电影磁共振成像（cine-MRI）已被提议作为一种非侵入性替代方法。我们通过在测压控制下用比沙可啶刺激高振幅传播收缩（HAPC），同时获取 cine-MRI，比较了 cine-MRI 与儿童测压获得的结肠运动模式。
在机构审查委员会批准后，纳入计划进行结肠测压的 FC 青少年患者。使用水灌注 8 腔导管进行结肠测压记录。在腔内比沙可啶输注后，同时进行约 30 分钟的降结肠 cine-MRI 序列采集。分析测压记录以确定 HAPC。使用时空运动 MRI 技术处理 MRI 图像。对两种技术的匿名运动结果进行视觉比较，以识别降结肠中的 HAPC。
分析了六名患者（三名男性）的数据（中位年龄 14 岁，范围 12-17 岁）。比沙可啶输注后，三名患者共显示 11 次 HAPC。在这 11 次 HAPC 中的两次，cine-MRI 记录了结肠的高活动度，在 7 次 HAPC 中记录了最小活动度，而两次 HAPC 未被记录。在三名 HAPC 无测压的患者中，cine-MRI 记录了结肠活动度。
在 FC 儿童中同时获取结肠 cine-MRI 和测压是可行的。在识别 HAPC 方面，它们的运动结果并没有完全重叠。需要进一步研究来阐明 cine-MRI 在这种情况下的作用。
