Gimondo P, Mirk P
Servizio di Radiologia, Ospedale S. Sebastiano Martire, Frascati (Rome), Italy.
AJR Am J Roentgenol. 1997 Jan;168(1):187-92. doi: 10.2214/ajr.168.1.8976944.
Many techniques currently used to study motility of the small intestine are too complex for large-scale use; other techniques provide information that is nonspecific and nonquantitative. The aim of the present study was to verify whether intestinal peristalsis can be seen and quantitatively assessed by means of duplex Doppler sonography.
We prospectively studied 152 normal fasting subjects using sonography, duplex Doppler sonography, and stethoscopic auscultation or phonocardiographic registration of bowel sounds in three abdominal sites. In each subject, we positioned the sample volume near the intestinal wall and then recorded Doppler signals of different amplitude and duration that related to bowel motility. Studies were repeated after ingestion of water (n = 55) and after a standard test meal (n = 73). The number of peristaltic waves and the number of bowel sounds revealed by the different imaging techniques were compared and statistically evaluated by Student's t test.
Intestinal movements were classified as peristaltic or nonperistaltic (mixing movements) based on amplitude and duration of Doppler signals. The mean number of peristaltic waves revealed by Doppler sonography was three per minute in fasting subjects, with no significant increase after ingestion of water (3.78 per min) or the test meal (3.92 per min). The mean number of bowel sounds obtained with auscultation and phonocardiographic recordings was significantly higher in fasting subjects (8.7 per min) and after ingestion of water (9.55 per min) or the test meal (12 per min).
Intestinal contractions produce Doppler signals of different amplitudes and duration, thus potentially allowing differentiation between peristaltic and nonperistaltic movements. This differentiation is not possible with auscultation or phonocardiographic registration because similar bowel sounds are produced by nonprogressive, mixing movements as well as by true peristaltic movements. Duplex Doppler sonography allows graphic visualization of intestinal movements that can be subjected to qualitative and quantitative analysis and may be suitable for the noninvasive study of small-bowel motility.
目前用于研究小肠蠕动的许多技术过于复杂，无法大规模应用；其他技术提供的信息不具有特异性且无法定量。本研究的目的是验证是否可以通过双功多普勒超声观察并定量评估肠道蠕动。
我们前瞻性地对152名正常空腹受试者进行了研究，在三个腹部部位使用超声、双功多普勒超声以及听诊或心音图记录肠鸣音。在每个受试者中，我们将取样容积置于肠壁附近，然后记录与肠蠕动相关的不同幅度和持续时间的多普勒信号。在摄入水（n = 55）和标准试验餐后（n = 73）重复进行研究。比较不同成像技术所显示的蠕动波数量和肠鸣音数量，并通过学生t检验进行统计学评估。
根据多普勒信号的幅度和持续时间，肠道运动被分类为蠕动性或非蠕动性（混合运动）。在空腹受试者中，多普勒超声显示的平均蠕动波数量为每分钟3次，摄入水后（每分钟3.78次）或试验餐后（每分钟3.92次）无显著增加。通过听诊和心音图记录获得的空腹受试者肠鸣音平均数量（每分钟8.7次）以及摄入水后（每分钟9.55次）或试验餐后（每分钟12次）显著更高。
肠道收缩产生不同幅度和持续时间的多普勒信号，从而有可能区分蠕动性和非蠕动性运动。听诊或心音图记录无法进行这种区分，因为非推进性混合运动以及真正的蠕动运动都会产生相似的肠鸣音。双功多普勒超声能够对肠道运动进行图形化可视化，可进行定性和定量分析，可能适用于小肠蠕动的无创研究。
