Giovagnorio F, Picarelli A, Di Giovambattista F, Mastracchio A
I Cattedra di Radiologia, Università La Sapienza, Rome, Italy.
AJR Am J Roentgenol. 1998 Sep;171(3):629-32. doi: 10.2214/ajr.171.3.9725286.
The aim of this study was to investigate with Doppler sonography the variations of resistance in the superior mesenteric artery, both at fasting and in the postprandial state, in patients with celiac disease.
Twenty-five patients with celiac disease (20 women, five men; mean age, 30 +/- 7 years) and 10 healthy volunteers (seven women, three men; mean age, 28 +/- 6 years) were examined with Doppler sonography. Nineteen patients were untreated (no dietary restrictions) and six patients were treated with a gluten-free diet at the time of the examination. Imaging was performed at both fasting and 15 min after an 1890-kJ meal. We introduced a parameter called "resistive difference," defined as the mathematic difference between the resistive index measured at fasting (highest value) and that measured at 15 min after the meal (lowest value) as a way to express the postprandial resistive change in the superior mesenteric artery.
Untreated patients with flat mucosa showed a resistive difference of 0.03 +/- 0.05, followed by untreated patients with mucosal subatrophy (0.05 +/- 0.04), treated patients (0.09 +/- 0.02), and healthy volunteers (0.12 +/- 0.04). A statistically significant difference was noticed between the resistive difference of healthy volunteers and both those of the untreated patients with subatrophy (p = .016) and of the patients with complete atrophy (p = .011), as well as between the resistive difference of the treated patients and both those of the untreated patients with subatrophy (p = .021) and of the patients with complete atrophy (p = .020).
We believe that Doppler measurement of resistive difference in the superior mesenteric artery can be an effective way to express severity of celiac disease and to document its regression after diet therapy.
本研究旨在通过多普勒超声检查，调查乳糜泻患者空腹和餐后状态下肠系膜上动脉阻力的变化。
对25例乳糜泻患者（20名女性，5名男性；平均年龄30±7岁）和10名健康志愿者（7名女性，3名男性；平均年龄28±6岁）进行多普勒超声检查。19例患者未接受治疗（无饮食限制），6例患者在检查时采用无麸质饮食治疗。在空腹和进食1890千焦食物后15分钟进行成像。我们引入了一个名为“阻力差异”的参数，定义为空腹时（最高值）测量的阻力指数与餐后15分钟测量的阻力指数（最低值）之间的数学差值，以此来表示肠系膜上动脉餐后阻力变化。
未治疗的扁平黏膜患者阻力差异为0.03±0.05，其次是未治疗的黏膜亚萎缩患者（0.05±0.04）、治疗患者（0.09±0.02）和健康志愿者（0.12±0.04）。健康志愿者与未治疗的亚萎缩患者（p = 0.016）和完全萎缩患者（p = 0.011）的阻力差异之间，以及治疗患者与未治疗的亚萎缩患者（p = 0.021）和完全萎缩患者（p = 0.020）的阻力差异之间，均存在统计学显著差异。
我们认为，通过多普勒测量肠系膜上动脉的阻力差异，可成为表达乳糜泻严重程度并记录饮食治疗后病情缓解情况的有效方法。
