AIM： To evaluate the effect of various methods of small bowel preparation on the transit time and the quality of visualization of the entire small bowel mucosa. METHODS： Ninety-five patients underwent capsule endosc...AIM： To evaluate the effect of various methods of small bowel preparation on the transit time and the quality of visualization of the entire small bowel mucosa. METHODS： Ninety-five patients underwent capsule endoscopy （CE） by easily swallowing the capsule. They were divided into three study groups according to the preparation used： group A （n = 26） by polyethylene glycol （PEG） liter or with sodium phosphate （SP） 12 h prior to the CE study; group B （n = 29） by erythromycin 1 h prior to the CE study; and group C （n = 40） without any preparation. Visualization ranged from good to satisfactory to poor. RESULTS： The gastric emptying time in the group prepared with erythromycin was shorter but without statistical significance and the small bowel transit time was unaffected. In elderly subjects prepared by PEG or SP, the gastric emptying time was significantly longer （163.7 rain, P = 0.05）. The transit times of the three sub-groups were not affected by gender or pathology. The grade of cleaning of the entire study group was 3.27±1.1. The erythromycin group presented significantly the worst quality of images （P = 0.05） compared to the other sub-groups. Age, gender, and pathology had no effect on the quality of the cleaning of the small bowel in the sub-groups. One （1.05%） case had no natural excretion. CONCLUSION： Erythromycin markedly reduces gastric emptying time, but has a negative effect on the quality of the image in the small bowel. The preparation of elderly subjects with PEG or SP has a negative effect on the small bowel transit time.展开更多
目的探讨超声造影(contrast-enhanced ultrasonography,CEUS)定量评估肝纤维化程度的可行性,筛选与纤维化程度密切相关的造影定量参数。方法将79例慢性乙肝患者根据病理分级(Scheuer评分系统)分为轻度纤维化组(S0、S1期,26例)、中度纤...目的探讨超声造影(contrast-enhanced ultrasonography,CEUS)定量评估肝纤维化程度的可行性,筛选与纤维化程度密切相关的造影定量参数。方法将79例慢性乙肝患者根据病理分级(Scheuer评分系统)分为轻度纤维化组(S0、S1期,26例)、中度纤维化组(S2、S3期,24例)和重度纤维化组(S4期和临床肝硬化,29例),分别进行超声造影检查并采集1 min的动态影像供脱机分析。于肝动脉、门静脉、肝实质和肝静脉等4个感兴趣区获得相应的时间-强度曲线及灌注时间参数[到达时间(arrival ti me,AT)和达峰时间(ti me to peak,TTP)]、灌注强度参数[峰值强度(peak intensity,PI)、强度增量(increased signal intensity,ISI)和曲线下面积(area under curve,AUC)],计算肝动-静脉渡越时间(hepatic artery to hepatic vein transit ti me,HA-HVTT)、门静脉-肝静脉渡越时间(portal vein to hepatic vein transit ti me,PV-HVTT)及肝实质-肝静脉渡越时间(parenchyma to hepatic veintransit ti me,PA-HVTT),比较各参数与肝纤维化程度的相关性。结果肝静脉AT随肝纤维化程度的加重而缩短(P<0.05),其余部位的灌注时间参数与纤维化程度无相关性。肝内渡越时间HA-HVTT、PV-HVTT和PA-HVTT与纤维化程度均呈负相关(r=-0.510 7,r=-0.764 5,r=-0.403 2;P=0.000),其中PV-HVTT在3组间均有差异(P<0.05)。灌注强度参数中仅门静脉的PI、ISI和肝实质的ISI与纤维化程度有一定的相关性(r=-0.431 0,r=-0.460 8,r=-0.280 3;P=0.013 6)。结论超声造影定量分析可获得肝内微循环灌注的多种参数,其中肝内渡越时间与肝纤维化程度密切相关,尤其PV-HVTT可间接评估肝纤维化程度。展开更多
Good preparation before endoscopic procedures is essential for successful visualization. The small bowel is difficult to evaluate because of its length and complex configuration. A meta-analysis was conducted of studi...Good preparation before endoscopic procedures is essential for successful visualization. The small bowel is difficult to evaluate because of its length and complex configuration. A meta-analysis was conducted of studies comparing small bowel visualization by capsule endoscopy with and without preparation. Medical data bases were searched for all studies investigating the preparation for capsule endoscopy of the small bowel up to July 31, 2007. Studies that scored bowel cleanness and measured gastric and small bowel transit time and rate of cecum visualization were included. The primary endpoint was the quality of bowel visualization. The secondary endpoints were transit times and proportion of examinations that demonstrated the cecum, with and without preparation. Meta-analysis was performed with StatDirect Statistical software, version 2.6.1 (http:// statsdirect.com). Eight studies met the inclusion criteria. Bowel visualization was scored as "good" in 78% of the examinations performed with preparation and 49% performed without (P < 0.0001). There were no significant differences in transit times or in the proportion of examinations that demonstrated the cecum with and without preparation. Capsule endoscopy preparation improves the quality of small bowel visualization, but has no effect on transit times, or demonstration of the cecum.展开更多
AIM: To compare the effect of oral erythromycin vs no preparation with prokinetics on the transit time and the image quality of capsule endoscopy (CE) in evaluating small bowel (SB) pathology. METHODS: We conducted a ...AIM: To compare the effect of oral erythromycin vs no preparation with prokinetics on the transit time and the image quality of capsule endoscopy (CE) in evaluating small bowel (SB) pathology. METHODS: We conducted a retrospective, blinded (to the type of preparation) review of 100 CE studies, 50 with no preparation with prokinetics from one medical center (Group A) and 50 from another center with administration of a single dose of 200 mg oral erythromycin 1 h prior to CE (Group B). Gastric, SB and total transit times were calculated, the presence of bile in the duodenum was scored, as was cleanliness within the proximal, middle and distal intestine. RESULTS: The erythromycin group had a slightly shorter gastric transit time (21 min vs 28 min, with no statistical significance). SB transit time was similar for both groups (all P > 0.05). Total transit time was almost identical in both groups. The rate of incomplete examination was 16% for Group A and 10% for Group B (P = 0.37). Bile and cleanliness scores in different parts of the intestine were similar for the two groups (P > 0.05). CONCLUSION: Preparation for capsule endoscopy with erythromycin does not affect SB or total transit time. It tends to reduce gastric transit time, but it does not increase the cecum-reaching rate. Erythromycin does not adversely affect image quality. We consider the routine use of oral erythromycin preparation as being unjustified, although it might be considered in patients with known prolonged gastric emptying time.展开更多
文摘AIM： To evaluate the effect of various methods of small bowel preparation on the transit time and the quality of visualization of the entire small bowel mucosa. METHODS： Ninety-five patients underwent capsule endoscopy （CE） by easily swallowing the capsule. They were divided into three study groups according to the preparation used： group A （n = 26） by polyethylene glycol （PEG） liter or with sodium phosphate （SP） 12 h prior to the CE study; group B （n = 29） by erythromycin 1 h prior to the CE study; and group C （n = 40） without any preparation. Visualization ranged from good to satisfactory to poor. RESULTS： The gastric emptying time in the group prepared with erythromycin was shorter but without statistical significance and the small bowel transit time was unaffected. In elderly subjects prepared by PEG or SP, the gastric emptying time was significantly longer （163.7 rain, P = 0.05）. The transit times of the three sub-groups were not affected by gender or pathology. The grade of cleaning of the entire study group was 3.27±1.1. The erythromycin group presented significantly the worst quality of images （P = 0.05） compared to the other sub-groups. Age, gender, and pathology had no effect on the quality of the cleaning of the small bowel in the sub-groups. One （1.05%） case had no natural excretion. CONCLUSION： Erythromycin markedly reduces gastric emptying time, but has a negative effect on the quality of the image in the small bowel. The preparation of elderly subjects with PEG or SP has a negative effect on the small bowel transit time.
文摘目的探讨超声造影(contrast-enhanced ultrasonography,CEUS)定量评估肝纤维化程度的可行性,筛选与纤维化程度密切相关的造影定量参数。方法将79例慢性乙肝患者根据病理分级(Scheuer评分系统)分为轻度纤维化组(S0、S1期,26例)、中度纤维化组(S2、S3期,24例)和重度纤维化组(S4期和临床肝硬化,29例),分别进行超声造影检查并采集1 min的动态影像供脱机分析。于肝动脉、门静脉、肝实质和肝静脉等4个感兴趣区获得相应的时间-强度曲线及灌注时间参数[到达时间(arrival ti me,AT)和达峰时间(ti me to peak,TTP)]、灌注强度参数[峰值强度(peak intensity,PI)、强度增量(increased signal intensity,ISI)和曲线下面积(area under curve,AUC)],计算肝动-静脉渡越时间(hepatic artery to hepatic vein transit ti me,HA-HVTT)、门静脉-肝静脉渡越时间(portal vein to hepatic vein transit ti me,PV-HVTT)及肝实质-肝静脉渡越时间(parenchyma to hepatic veintransit ti me,PA-HVTT),比较各参数与肝纤维化程度的相关性。结果肝静脉AT随肝纤维化程度的加重而缩短(P<0.05),其余部位的灌注时间参数与纤维化程度无相关性。肝内渡越时间HA-HVTT、PV-HVTT和PA-HVTT与纤维化程度均呈负相关(r=-0.510 7,r=-0.764 5,r=-0.403 2;P=0.000),其中PV-HVTT在3组间均有差异(P<0.05)。灌注强度参数中仅门静脉的PI、ISI和肝实质的ISI与纤维化程度有一定的相关性(r=-0.431 0,r=-0.460 8,r=-0.280 3;P=0.013 6)。结论超声造影定量分析可获得肝内微循环灌注的多种参数,其中肝内渡越时间与肝纤维化程度密切相关,尤其PV-HVTT可间接评估肝纤维化程度。
文摘Good preparation before endoscopic procedures is essential for successful visualization. The small bowel is difficult to evaluate because of its length and complex configuration. A meta-analysis was conducted of studies comparing small bowel visualization by capsule endoscopy with and without preparation. Medical data bases were searched for all studies investigating the preparation for capsule endoscopy of the small bowel up to July 31, 2007. Studies that scored bowel cleanness and measured gastric and small bowel transit time and rate of cecum visualization were included. The primary endpoint was the quality of bowel visualization. The secondary endpoints were transit times and proportion of examinations that demonstrated the cecum, with and without preparation. Meta-analysis was performed with StatDirect Statistical software, version 2.6.1 (http:// statsdirect.com). Eight studies met the inclusion criteria. Bowel visualization was scored as "good" in 78% of the examinations performed with preparation and 49% performed without (P < 0.0001). There were no significant differences in transit times or in the proportion of examinations that demonstrated the cecum with and without preparation. Capsule endoscopy preparation improves the quality of small bowel visualization, but has no effect on transit times, or demonstration of the cecum.
文摘AIM: To compare the effect of oral erythromycin vs no preparation with prokinetics on the transit time and the image quality of capsule endoscopy (CE) in evaluating small bowel (SB) pathology. METHODS: We conducted a retrospective, blinded (to the type of preparation) review of 100 CE studies, 50 with no preparation with prokinetics from one medical center (Group A) and 50 from another center with administration of a single dose of 200 mg oral erythromycin 1 h prior to CE (Group B). Gastric, SB and total transit times were calculated, the presence of bile in the duodenum was scored, as was cleanliness within the proximal, middle and distal intestine. RESULTS: The erythromycin group had a slightly shorter gastric transit time (21 min vs 28 min, with no statistical significance). SB transit time was similar for both groups (all P > 0.05). Total transit time was almost identical in both groups. The rate of incomplete examination was 16% for Group A and 10% for Group B (P = 0.37). Bile and cleanliness scores in different parts of the intestine were similar for the two groups (P > 0.05). CONCLUSION: Preparation for capsule endoscopy with erythromycin does not affect SB or total transit time. It tends to reduce gastric transit time, but it does not increase the cecum-reaching rate. Erythromycin does not adversely affect image quality. We consider the routine use of oral erythromycin preparation as being unjustified, although it might be considered in patients with known prolonged gastric emptying time.
