Postprandial changes in gastrointestinal function and transit in cystic fibrosis assessed by Magnetic Resonance Imaging
Postprandial changes in gastrointestinal function and transit in cystic fibrosis assessed by Magnetic Resonance Imaging
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DOI：
10.1016/j.jcf.2020.06.004
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发表时间：
2021-08-24
影响因子：
5.2
通讯作者：
Smyth, Alan R.
中科院分区：
文献类型：
--
作者：
Ng, Christabella;Dellschaft, Neele S.;Smyth, Alan R.
背景：囊性纤维化（CF）是一种多系统遗传性疾病，影响全球超过72，000人。大多数CF患者会出现胃肠道症状，并可能出现并发症。然而，CF肠道疾病的机制还不清楚。我们使用磁共振成像（MRI）评估CF的肠道功能和转运。我们假设口盲肠通过时间（OCTT）是较长的CF，与较低的小肠水含量（SBWC）。方法：12个CF患者年龄在12 - 40岁和12个年龄和性别匹配的对照组进行了一系列MRI超过1天的标准化膳食。主要终点是OCTT，通过盲肠中出现食团进行评估。其他测量包括校正SBWC和校正结肠体积（曲线下面积，AUC），胃半排空时间和胃肠道症状。结果：CF组的OCTT较长（CF组330分钟[270，> 360] vs.对照组210分钟[173，315]，p = 0.04），胃半排空时间无差异。CF中校正的SBWC较高（CF 62 L. min/m（2）[36，80] vs对照组34 L. min/m（2）[28，41]，p = 0.021）; T240和T300之间餐后极轻微降低（CF 13 mL/m（2）[-13，57] vs.对照组102 mL/m（2）[67，108]，p = 0.002）表明回肠排空受损。CF组的校正结肠容积较高（CF组为186 L. min/m（2）[167，206]，对照组为123 L. min/m（2）[89，146]，p = 0.012）。胃肠道症状没有差异。结论：MRI提供了新的见解CF的病理生理。亚临床回肠梗阻可能比以前认为的更普遍。胃肠道MRI显示有希望作为CF的研究工具。(C)2020年欧洲囊性纤维化协会。Elsevier B.V.出版，保留所有权利。
Background: Cystic fibrosis (CF) is a multi-system genetic disorder affecting >72,000 people worldwide. Most CF patients experience gastrointestinal symptoms and can develop complications. However, the mechanisms of CF gut disease are not well understood. We evaluated gut function and transit in CF using magnetic resonance imaging (MRI). We hypothesised oro-caecal transit time (OCTT) is longer in CF; with lower small bowel water content (SBWC).Methods: Twelve CF patients aged 12-40 years and 12 age and sex-matched controls underwent serial MRIs over 1 day with standardised meals. The primary endpoint was OCTT, assessed by the appearance of a food bolus in the caecum. Other measures included corrected SBWC and corrected colonic volume (both area under the curve, AUC), gastric half-emptying time and gastrointestinal symptoms.Results: OCTT was longer in CF (CF 330 mins [270, >360] vs. controls 210 mins [173, 315], p = 0.04), with no difference in gastric half-emptying times. Corrected SBWC was higher in CF (CF 62 L.min/m(2) [36, 80] vs. controls 34 L.min/m(2) [28, 41], p = 0.021); minimal postprandial decrease between T240 and T300 (CF 13 mL/m(2) [-13, 57] vs. controls 102 mL/m(2) [67, 108], p = 0.002) suggests impaired ileal emptying. Corrected colonic volumes were higher in CF (CF 186 L.min/m(2) [167, 206] vs. controls 123 L.min/m(2) [89, 146], p = 0.012). There were no differences in gastrointestinal symptoms.Conclusions: MRI provides novel insights into CF pathophysiology. Sub-clinical ileal obstruction may be more prevalent than previously thought. Gastrointestinal MRI shows promise as an investigational tool in CF. (C) 2020 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.