Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK; Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK.
Department of Paediatric Radiology, Southampton Children's Hospital, Southampton, UK.
Clin Nutr ESPEN. 2021 Apr;42:233-238. doi: 10.1016/j.clnesp.2021.01.031. Epub 2021 Feb 13.
Paediatric Crohn's disease (CD) has been associated with undernutrition. Accurate and accessible measures of body composition would provide data to personalise nutritional therapy. We assessed feasibility of MRI-derived measures of psoas cross-sectional area (PCSA) in paediatric CD and correlated with anthropometric and bioelectrical impedance spectroscopy (BIS) measures.
MRI small bowel/pelvis images of patients with CD, aged <18 years, were retrieved. Patients with concurrent anthropometric and BIS measurements were eligible for inclusion. The PCSA at L3 was calculated by two assessors and combined. To assess reproducibility of measures we calculated the coefficient of variation (CoV). Age, height-Z-scores, weight-Z-scores and BIS measures were correlated with PCSA. Using normal paediatric data from CT-scans we derived psoas area Z-scores for our cohort.
10 patients were included. Mean age at MRI scan was 14.6 years (11.7-16.3). PCSA was calculated for all MRI scans. There was high reproducibility between measurers, mean CoV 0.099. There was a significant positive correlation between PCSA and BIA-derived fat free mass, Pearson correlation coefficient (PCC) 0.831, p = 0.003. Correlation coefficients for PCSA and Height-for-age Z-score, weight-for-age -Z-score and age were PCC 0.343- p = 0.33, PCC = 0.222- p = 0.54, and PCC 0.6034- p = 0.065, respectively. The mean PCSA Z-score was -1.81, with 70% of the patients having a Z-score < -2.0.
These data demonstrate the feasibility of deriving measures of body composition from routine MRI imagine. There was significant positive correlation between PCSA and BIS-derived lean mass. Further studies are required to confirm applicability of normal ranges prior to routine clinical implementation.
儿科克罗恩病（CD）与营养不良有关。准确且易于获取的身体成分测量方法可以为营养治疗提供数据支持，以实现个体化治疗。本研究旨在评估 MRI 测量的腰 3 节段竖脊肌横截面积（PCSA）在儿科 CD 中的可行性，并与人体测量和生物电阻抗分析（BIA）测量结果进行相关性分析。
回顾性分析了年龄<18 岁、患有 CD 的患儿的 MRI 小肠/骨盆图像。纳入同时具有人体测量和 BIA 测量数据的患儿。由两名评估者计算并合并 L3 节段的 PCSA。为评估测量的可重复性，我们计算了变异系数（CoV）。将年龄、身高 Z 评分、体重 Z 评分和 BIA 测量结果与 PCSA 进行相关性分析。使用 CT 扫描获得的正常儿童数据，为我们的队列计算了竖脊肌面积 Z 评分。
共纳入 10 例患儿，MRI 扫描时的平均年龄为 14.6 岁（11.7-16.3 岁）。所有 MRI 扫描均计算了 PCSA。两名评估者之间的测量具有很高的重复性，平均 CoV 为 0.099。PCSA 与 BIA 衍生的去脂体重呈显著正相关，Pearson 相关系数（PCC）为 0.831，p=0.003。PCSA 与身高 Z 评分、体重 Z 评分和年龄的相关系数分别为 PCC 0.343（p=0.33）、PCC 0.222（p=0.54）和 PCC 0.6034（p=0.065）。平均 PCSA Z 评分为-1.81，70%的患儿 PCSA Z 评分<-2.0。
这些数据表明，从常规 MRI 图像中获取身体成分测量值是可行的。PCSA 与 BIA 衍生的瘦体重呈显著正相关。在常规临床应用之前，还需要进一步研究以确认正常范围的适用性。
