Publication: Novel study to delineate, measure and to compare the orientation of duodenum using mri in normal population and patient with functional dyspepsia: A pilot study in Hospital Universiti Sains Malaysia
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Date
2022
Authors
Ji, Tiong Wen
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Abstract
Background: Dyspepsia is a bothersome symptom affecting worldwide population while functional dyspepsia (FD) is defined as dyspepsia without organic causes. The exact pathophysiology and relation between the duodenum and dyspepsia remain under active investigation. MRI is capable to reproduce the duodenum anatomy without exposing the patient to the risk of radiation, hence facilitate the investigation to find the relationship between dyspepsia and duodenum. Methods: This is a prospective study that was conducted in Hospital Universiti Sains Malaysia (HUSM), Kubang Kerian Kelantan from 21 June 2021 to 1st March 2022. A total of 18 subjects who met the inclusion and exclusion was included in this study. Among the recruited participants, 14 of them were normal healthy volunteers (control group) which comprised of 7 male and 7 female participants (age range:22 -36 years old), mean age 27.1) without dyspeptic symptoms or previous medical and surgical history. While a total of 4 FD female patients with a mean age of 49.25, age range from 36-65; who is under KPP HUSM follow up. All eligible subjects underwent non-contrasted upper abdominal MRI 20 minutes after drinking 250mls of milk as oral contrast. MRI images were reviewed in PACS, and segmentation of the duodenum was performed. Measurement of duodenal length and angulation, determination of duodenal angulation were made based on the 3D duodenal segmentation images. All data were analyzed using Statistical Product and Service Solutions (SPSS). Mann Whitney test was used to correlate the segmental duodenal length and duodenum angulation. Fisher Exact test was used to detect the association between the control group and FD patients Results: Only inferior duodenal angulation showed a statistically significant difference (p-value = 0.025) between the control population and FD patients. There were no statistically significant differences in the segmental duodenal length, duodenal length, and superior duodenal angulation between the control population and FD patients. Fisher’s exact test showed there was no statistically significant correlation in duodenal orientation with the control population or FD patients (p-value: 0.323). Conclusion: Current advancement in the MRI sequence and post-processing technique have shown it as a promising and safe tool in duodenum imaging. It may play a role in the management of FD patient in the future.
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Keywords
Functional dyspepsia , abdominal Magnetic resonance imaging abdomen