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Sun B, Liu J, Li S, Lovell JF, Zhang Y. Imaging of Gastrointestinal Tract Ailments. J Imaging 2023; 9:115. [PMID: 37367463 DOI: 10.3390/jimaging9060115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/20/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
Gastrointestinal (GI) disorders comprise a diverse range of conditions that can significantly reduce the quality of life and can even be life-threatening in serious cases. The development of accurate and rapid detection approaches is of essential importance for early diagnosis and timely management of GI diseases. This review mainly focuses on the imaging of several representative gastrointestinal ailments, such as inflammatory bowel disease, tumors, appendicitis, Meckel's diverticulum, and others. Various imaging modalities commonly used for the gastrointestinal tract, including magnetic resonance imaging (MRI), positron emission tomography (PET) and single photon emission computed tomography (SPECT), and photoacoustic tomography (PAT) and multimodal imaging with mode overlap are summarized. These achievements in single and multimodal imaging provide useful guidance for improved diagnosis, staging, and treatment of the corresponding gastrointestinal diseases. The review evaluates the strengths and weaknesses of different imaging techniques and summarizes the development of imaging techniques used for diagnosing gastrointestinal ailments.
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Affiliation(s)
- Boyang Sun
- Key Laboratory of Systems Bioengineering, School of Chemical Engineering and Technology, Frontiers Science Center for Synthetic Biology (Ministry of Education), Tianjin University, Tianjin 300350, China
| | - Jingang Liu
- Key Laboratory of Systems Bioengineering, School of Chemical Engineering and Technology, Frontiers Science Center for Synthetic Biology (Ministry of Education), Tianjin University, Tianjin 300350, China
| | - Silu Li
- Key Laboratory of Systems Bioengineering, School of Chemical Engineering and Technology, Frontiers Science Center for Synthetic Biology (Ministry of Education), Tianjin University, Tianjin 300350, China
| | - Jonathan F Lovell
- Department of Biomedical Engineering, The State University of New York at Buffalo, Buffalo, NY 14260, USA
| | - Yumiao Zhang
- Key Laboratory of Systems Bioengineering, School of Chemical Engineering and Technology, Frontiers Science Center for Synthetic Biology (Ministry of Education), Tianjin University, Tianjin 300350, China
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Liu Q, Fang W, Zhao P, He Y, Gao H, Ke X. Three-dimensional high-resolution anorectal manometry: A comparative pilot study with X-ray defaecography. Medicine (Baltimore) 2022; 101:e31682. [PMID: 36550796 PMCID: PMC9771284 DOI: 10.1097/md.0000000000031682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Three-dimensional high-resolution anorectal manometry (3DHRAM) is a new technique that can explore anorectal disorders and provide interesting topographic data for the diagnosis of pelvic floor disorders such as paradoxical puborectalis syndrome (PPS). Our object was to evaluate whether 3DHRAM can reliably diagnose PPS already diagnosed with X-ray defaecography, which is considered to be the gold standard. All patients being tested in our department for dyschezia by 3D-HRAM and X-ray defecography were eligible for the study. The 3DHRAM results were compared with X-ray defecography. The sensitivity, specificity, and positive and negative predictive values were calculated for various 3DHRAM criteria to propose a diagnostic strategy for PPS. Twenty-three patients presented with PPS on X-ray defaecography. On 3DHRAM, according to our diagnostic strategy, the kappa value was 0.706, with a positive predictive value of 71.88% [95% CI, 53.02-85.60], a specificity of 80.43% [95% CI, 65.62-90.13], a sensibility of 95.83% [95% CI, 76.98-99.78], and area under curve value was 0.922. In this study, 3DHRAM was used to diagnose PPS with the same degree of reliability as X-ray defaecography, and we confirmed its use in the diagnosis of pelvic floor disorders. Further studies will be necessary to define classifications for these new anatomic data from 3DHRAM.
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Affiliation(s)
- Qihong Liu
- The Second People’s Hospital Affiliated to Fujian University of Chinese Medicine, Fuzhou, China
- Fujian Province Traditional Chinese Medicine Spleen and Stomach Clinical Medicine Research Center, Fuzhou, China
- National Health Commission Traditional Chinese Medicine Spleen and Stomach Clinical Key Specialty, Fuzhou, China
| | - Wenyi Fang
- The Second People’s Hospital Affiliated to Fujian University of Chinese Medicine, Fuzhou, China
- Fujian Province Traditional Chinese Medicine Spleen and Stomach Clinical Medicine Research Center, Fuzhou, China
- National Health Commission Traditional Chinese Medicine Spleen and Stomach Clinical Key Specialty, Fuzhou, China
| | - Peilin Zhao
- The Second People’s Hospital Affiliated to Fujian University of Chinese Medicine, Fuzhou, China
- Fujian Province Traditional Chinese Medicine Spleen and Stomach Clinical Medicine Research Center, Fuzhou, China
- National Health Commission Traditional Chinese Medicine Spleen and Stomach Clinical Key Specialty, Fuzhou, China
| | - Yanqin He
- The Second People’s Hospital Affiliated to Fujian University of Chinese Medicine, Fuzhou, China
- Fujian Province Traditional Chinese Medicine Spleen and Stomach Clinical Medicine Research Center, Fuzhou, China
- National Health Commission Traditional Chinese Medicine Spleen and Stomach Clinical Key Specialty, Fuzhou, China
| | - HaiHua Gao
- The Second People’s Hospital Affiliated to Fujian University of Chinese Medicine, Fuzhou, China
- Fujian Province Traditional Chinese Medicine Spleen and Stomach Clinical Medicine Research Center, Fuzhou, China
- National Health Commission Traditional Chinese Medicine Spleen and Stomach Clinical Key Specialty, Fuzhou, China
| | - Xiao Ke
- The Second People’s Hospital Affiliated to Fujian University of Chinese Medicine, Fuzhou, China
- Fujian Province Traditional Chinese Medicine Spleen and Stomach Clinical Medicine Research Center, Fuzhou, China
- National Health Commission Traditional Chinese Medicine Spleen and Stomach Clinical Key Specialty, Fuzhou, China
- * Correspondence: Xiao Ke, Department of Spleen and Stomach, The Second Affiliated Hospital to Fujian University of Traditional Chinese Medicine, 282 Wusi Road, Fuzhou, People’s Republic of China (e-mail: )
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García-Mejido JA, García-Pombo S, Fernández-Conde C, Borrero C, Fernández-Palacín A, Sainz-Bueno JA. The Role of Transperineal Ultrasound for the Assessment of the Anorectal Angle and Its Relationship with Levator Ani Muscle Avulsion. Tomography 2022; 8:1270-1276. [PMID: 35645391 PMCID: PMC9149989 DOI: 10.3390/tomography8030105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/28/2022] [Accepted: 05/01/2022] [Indexed: 11/23/2022] Open
Abstract
The relationship between the anorectal angle (ARA) and the levator ani muscle (LAM) is well known. In this study, we aimed to demonstrate that the ARA changes when LAM avulsion occurs after vaginal delivery. This was a secondary, observational retrospective study with data obtained from three previous studies. Using transperineal ultrasound, the presence of avulsion was assessed when abnormal insertion of the LAM was observed in three central slices. In addition, the ARA was assessed in the midsagittal plane (at rest, in Valsalva and at maximum contraction) as the angle between the posterior border of the distal part of the rectum and the central axis of the anal canal. The ARA was higher in patients with bilateral LAM avulsion than in patients without LAM avulsion at rest (131.8 ± 14.1 vs. 136.2 ± 13.8), in Valsalva (129.4 ± 15.5 vs. 136.5 ± 14.4) and at maximum contraction (125.7 ± 15.5 vs. 132.3 ± 13.2). The differences between both groups expressed as the odds ratio (OR) adjusted for maternal age were 1.031 (95% confidence interval (CI), 1.001–1.061; p = 0.041) at rest, 1.036 (95% CI, 1.008–1.064; p = 0.012) in Valsalva and 1.031 (95% CI, 1.003–1.059; p = 0.027) at maximum contraction. In conclusion, LAM avulsion produces an increase in the ARA at rest, during contraction and in Valsalva, especially in cases of bilateral LAM avulsion.
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Affiliation(s)
- José Antonio García-Mejido
- Department of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, Spain; (S.G.-P.); (C.F.-C.); (C.B.); (J.A.S.-B.)
- Department of Obstetrics and Gynecology, University of Seville, 41014 Seville, Spain
- Correspondence: (J.A.G.-M.); (A.F.-P.)
| | - Sara García-Pombo
- Department of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, Spain; (S.G.-P.); (C.F.-C.); (C.B.); (J.A.S.-B.)
| | - Cristina Fernández-Conde
- Department of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, Spain; (S.G.-P.); (C.F.-C.); (C.B.); (J.A.S.-B.)
| | - Carlota Borrero
- Department of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, Spain; (S.G.-P.); (C.F.-C.); (C.B.); (J.A.S.-B.)
- Department of Obstetrics and Gynecology, University of Seville, 41014 Seville, Spain
| | - Ana Fernández-Palacín
- Biostatistics Unit, Department of Preventive Medicine and Public Health, University of Seville, 41014 Seville, Spain
- Correspondence: (J.A.G.-M.); (A.F.-P.)
| | - José Antonio Sainz-Bueno
- Department of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, Spain; (S.G.-P.); (C.F.-C.); (C.B.); (J.A.S.-B.)
- Department of Obstetrics and Gynecology, University of Seville, 41014 Seville, Spain
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Du Y, Zhu J, Li H, Fu Z, He Z. Value of Defecography in the Diagnostic and Therapeutic Management of the Modified Wells Procedure for Rectal Prolapse. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:2219330. [PMID: 35480080 PMCID: PMC9013572 DOI: 10.1155/2022/2219330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 11/17/2022]
Abstract
The main aim of this study was to explore the role of defecography in the preoperative diagnosis and postoperative evaluation of rectal prolapse surgery (modified Wells procedure). We collected and summarized the X-ray performance and then analyzed the results of 107 patients with defecatory dysfunction who underwent defecography from January 2020 to March 2021. Furthermore, the preoperative and 6-month postoperative defecography results and clinical symptoms of 25 patients who underwent rectal prolapse surgery (modified Wells procedure) were compared. Results showed that among the 107 patients with defecation dysfunction, women had worse defecography results than men (P < 0.01). A total of 25 patients successfully completed the surgery without complications such as infection and intestinal fistula and there was no recurrence at 12 months of follow-up. Compared with the preoperative results, anorectal angle during defecation, the depth of rectocele, and perineal descent were significantly improved after the surgery (P < 0.01). Moreover, the patient's feeling of obstructed defecation and incomplete defecation was significantly relieved compared to that before the procedure (P < 0.01). In conclusion, defecography can be used to diagnose rectal prolapse preoperatively and evaluate the surgical effect combined with clinical symptoms postoperatively, which provides a clinical reference.
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Affiliation(s)
- Yangbin Du
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Jinxin Zhu
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Hailun Li
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Zhiqiang Fu
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Zhenyu He
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
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Disorders of anorectal motility: Functional defecation disorders and fecal incontinence. J Visc Surg 2022; 159:S40-S50. [DOI: 10.1016/j.jviscsurg.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Curative Effect and Mechanism of Guiren Runchang Granules on Morphine-Induced Slow Transit Constipation in Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:5493192. [PMID: 33029167 PMCID: PMC7530485 DOI: 10.1155/2020/5493192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/13/2020] [Accepted: 07/30/2020] [Indexed: 02/07/2023]
Abstract
Recent studies have identified the curative effects of traditional Chinese medicine for constipation. The mechanism of action of Guiren Runchang granules (GRGs) in the treatment of slow transit constipation (STC) was evaluated in this study. Here, we assessed the efficacy of GRG by comparing the differences in fecal characteristics, stool weight, and intestinal transit rate (ITR) among 6 groups (n = 12/group), which were administered three concentrations of GRG, mosapride, and saline. The influence of GRG on the SCF/c-kit pathway, AQP4, and serum motilin of mice was assessed through ELISA, western blot, and immunohistochemical analysis. The dry weight of mouse feces at 24 hr and ITR in the MD (medium-dose GRG; 9.44 g/kg/d) and HD (high-dose GRG; 18.88 g/kg/d) groups was higher than that in the MC (model control) group. The serum motilin of morphine-induced mice level was lower in the MC group than in the NC (normal control) group, and this condition was improved in the HD group. The HD group expressed significantly higher levels of SCF and c-kit protein but lower levels of AQP4 and simultaneously presented more SCF-positive and c-kit-positive cells. However, no differences in the serum SCF level were found among the six groups. Certain concentrations of GRG are effective in STC mice, the potential mechanism of which may be associated with repairing the SCF/c-kit pathway and reducing the expression of AQP4 in the colon. GRG improved the serum motilin level but had no influence on the serum SCF level.
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